The posting
Purpose: Care Management is a service that helps children with chronic physical or emotional issues obtain and utilize the medical, social and community services they need to get and stay healthy. Care Coordinators learn all they can about the child and family’s unique needs. They work with other care providers to develop a plan of care and help members determine and take the actions needed to make and keep appointments, adhere to medications, obtain educational and health advocacy, and access benefits.
Position Overview: Care Coordinators link children who have chronic medical or behavioral health conditions to the services they need to stay as healthy as possible and avoid unnecessary trips to the emergency room. Care coordinators encourage the clients (members) they serve to use those services to optimize their health outcomes. Working in a team setting and primarily in the field, Care Coordinators assess risks and needs, develop person centered care plans, track and arrange appointments, educate members and coordinate other aspects of members’ health and community services. Requires some evening availability with the role. Additional responsibilities will be added.
RESPONSIBILITIES include but NOT limited to:
Integration of medical, specialized and behavioral health services in addition to social support and/or educational support services. Periodic assessment of a member’s medical and behavioral health needs as well as their compliance with recommended treatments. Collaborative development of an Individualized Plan of Care with the member, the member’s family and/or caregivers in addition to other service providers. Conduct and document outreach efforts for new referrals to facilitate enrollment conversions. Provide care management services, ensuring members access and retain needed services as outlined in their care plans, including Acute and Primary Medical Care, Preventative Medical Care (including metabolic screening), Home Health Care, Chemical Dependency Services, Behavioral Health Services, Community Social Support Services, Housing, State and Federal Entitlements, Educational Services, and involvement with child welfare, juvenile justice, or criminal justice institutions. Tracking all specialty medical, behavioral and support service referrals made for patient using Health Information Technology (HIT) and other electronic databases required. Monitor appropriate discharge and ongoing care planning at pre- and post-transition for individuals transitioning to community. Establish collaborative relationships and serve as a liaison with community providers, Managed Care Plans, schools, and medical providers. Complete casework documentation promptly as required, maintaining adherence to productivity standards. Attend and participate in program meetings and weekly supervisory sessions as scheduled. Provide referrals and reassess members' need for ongoing care coordination to ensure access to necessary services. Sharing knowledge and experience with other team members to support the team’s overall service provision efforts.
Carrying an agency-provided cell phone, laptop and hotspot for hybrid use. Respond to members' questions, needs, and crises during regular and after business hours via the program's emergency cell phone, which is rotated among care coordinators. Perform other duties as assigned.
EDUCATIONAL / TRAINING REQUIRED (List all that is required to achieve this position):
A bachelor’s degree with a major or concentration in social work, psychology, nursing, rehabilitation, education, occupational therapy, physical therapy, recreation therapy, counseling, community mental health, child and family studies, sociology, or speech and hearing PLUS, Two (2) years of experience in providing direct services, or a substantial number of case management services, to mentally disabled or chronically ill or homeless children with complex social or healthcare needs.
EXPERIENCE REQUIRED / LANGUAGE PREFERENCE (List what the desire to reach goals):
A valid driver’s license and access to a vehicle (for Staten Island); A valid NYS ID for all boroughs. Specific experience with the target population is required to work with Children. Experience working in interdisciplinary teams; experience providing care management or care coordination in a medical or behavioral health environment; experience working with the chronically ill. Excellent written communication, verbal communication and customer service skills
Fluency in a second language such as Spanish, Mandarin, or Russian is preferred currently.
COMPUTER SKILLS REQUIRED (List the computer skills needed):
Intermediate computer proficiency
VISUAL AND MANUAL DEXIERITY:
Ability to read/input data and documents, including spreadsheets, reports and Electronic Health Records in printed form and on computer screens
Able to input data into various agencies and city/state electronic health records Limited applications of manual dexterity and hand-eye coordination. Manual dexterity and hand-eye coordination to conduct significant data entry and record keeping required
WORK ENVIRONMENT / PHYSICAL EFFORT
The work environment varies from office-based interaction with co-workers and members (20-40% of the time) to serving members in their homes and in other community settings (e.g. hospitals, clinics, benefit offices) 60%-80% of the time. While the offices of the Jewish Board are accessible in accordance with the ADA, the sites to which staff may need to travel may or may not be. To perform the essential functions of this job, the candidate must be able to travel within New York City carrying equipment such as a notebook, forms, laptop, mobile hotspot and cell phone weighing up to approximately 10 pounds. To perform the essential functions of this job, the candidate is routinely required to sit (30% of the time), stand (35% of the time), and travel to and from appointments using varied public and private transportation options (35% of the time).
Risks/hazards associated with the position are those which may be encountered travelling around New York City. Frequent travel throughout Bronx, Brooklyn, Manhattan. The position is currently hybrid, with three office days and two hybrid days, but it may transition to 100% in-person based on program needs.
