Care Coordinator

General Statement of Job

 The Care Coordinator plays a vital role in the outpatient behavioral health clinic by supporting the well-being of patients who are managing medical, substance use, and behavioral health challenges. This role requires close collaboration with both patients and medical staff to ensure that all aspects of care are coordinated and delivered efficiently. The Care Coordinator helps manage patient schedules, facilitates treatment planning, supports medication management, and ensures that all patients receive the appropriate care in a safe and supportive environment. The care coordinator is primarily responsible for facilitating higher levels of care referrals that are acute to assist the patient, as well as coordinating with looking at social needs, assessing those and coordinating all social services. The Care Coordinator is integral in enhancing the patient experience while fostering a holistic, integrated approach to treatment. Specific Duties and Responsibilities 

Essential Functions: 

• Willingness to Take Initiative: Internally driven to seek out patients needing care coordination when not actively engaged with a patient via outreach by screening charts, following referrals, and following-up on previously seen patients without being prompted to do so. 
• Patient Care Support: Assist patients with coordinating their appointments, ensuring they receive timely and consistent care. 
• Engagement: Will use motivational interviewing techniques to engage patient in care plan. 
• Treatment Coordination: Collaborate with medical and behavioral health staff to facilitate seamless care delivery and ensure that treatment plans are followed. 
• Documentation and Monitoring: Accurately document patient behaviors, progress, and any concerns related to treatment. Ensure that records are up-to-date and accessible for the medical team.
• Treatment and Goal Planning: Collaborate with medical and behavioral health staff to create and update personalized treatment plans, ensuring that each patient’s goals are clear, measurable, and aligned with their overall care needs.
• Patient Advocacy: Serve as the primary point of contact for patients, addressing any questions or concerns related to their treatment and ensuring they feel supported throughout their journey.
• Environment Maintenance: Help maintain a safe, secure, and therapeutic clinic environment, ensuring that patient safety and confidentiality are prioritized.
• Linkage to Community Resources: Connect patients to community services and resources, including housing, employ
• Collaborating with other professionals: Work effectively with treatment staff, therapists, and other healthcare professionals to provide comprehensive care. 
• Operations: Care Coordination have a dual role and are expected to perform complete Patient Registrations including but not limited to, assessing and determining the sliding fee’s scales, insurance verification, review and obtaining patient consent forms, review and securing patientauthorized releases of information, reconciliation of cash collections, end of day reports related to patient registration.
•  Assessing Patient Needs: Evaluate patients' healthcare needs by reviewing medical history, current conditions, and social circumstances to create a personalized care plan. 
• Developing and Implementing Care Plans: Collaborate with healthcare providers, patients, and families to design and implement comprehensive care plans. These plans often include medical, emotional, and social needs. 
• Coordinating Healthcare Services: Ensure that patients access the necessary healthcare services, such as doctor appointments, therapy sessions, or home health visits. This may involve arranging transportation or ensuring there is communication between healthcare providers.
• Monitoring and Tracking Progress: Regularly assess and monitor patients' progress against the care plan. This includes checking on health outcomes, making necessary adjustments to treatment, and ensuring continuity of care. 
• Liaising with Healthcare Providers and community partners: Communicate regularly with doctors, nurses, specialists, and other healthcare professionals to ensure that all aspects of the patient’s care are aligned and coordinated. 
• Patient Education and Advocacy: Educate patients and their families about health conditions, treatment options, and self-care strategies. Also, advocate for patients’ needs within the healthcare system. 
• Managing Resources: Ensure that patients receive appropriate resources, including medical equipment, medications, and community services. This may also include assisting with insurance paperwork. 
• Providing Emotional Support: Offer emotional and practical support to patients and families, helping them navigate the healthcare system and cope with the challenges of illness or disability. 
• Documentation and Reporting: Keep accurate and up-to-date records of patient interactions, care plans, treatments, and progress. These records are often used for ongoing care or legal purposes.
• Facilitating Discharge and Follow-up Care: Ensure a smooth transition when patients are discharged from hospitals or other care facilities and coordinate necessary follow-up services to ensure continuous care 

Additional Duties: This job description reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. The omission of specific statements of duties does not exclude them from the position. Management of the Health Care District of Palm Beach County reserves the right to assign duties not listed herein as necessary to accomplish the goals of the organization. 

Education: 

High school diploma or G.E.D. required. Bachelor’s degree in a health-related field or equivalent experience in healthcare coordination or behavioral health preferred but not required. Case management certification (Certified Case Manager/Certified Behavioral Health Case Manager) preferred but not required.

Experience: 

Experience working in behavioral health or substance use treatment settings is preferred but not required. Care coordination or case management experience in medical settings or social services is preferred but not required. 

Strong organizational skills with the ability to multitask in a fast-paced, dynamic environment. Excellent communication and interpersonal skills, with the ability to work effectively with patients, families, and healthcare professionals. 

Ability to maintain confidentiality and comply with all regulatory and legal requirements. 

Certification: 

Peer counselor certification is preferred, as well as peer supervisor certification. Current BLS certification required 

Licensure:

Valid Florida driver’s license required. 

Registrations: 

N/A 

Training: 

Knowledge of Microsoft applications required. Possesses an intimate knowledge of Microsoft Excel including creating spreadsheets and utilization of its applications and functions.