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Care Coordinator - Lead

Columbia River Mental Health Services
Vancouver, WA Full Time
POSTED ON 2/6/2025
AVAILABLE BEFORE 5/6/2025

Job Description

Job Description

Care Coordinator Lead

Reports to : Program Director

Department : Health Homes / #02

Pay Grade : D

Classification / FLSA : Clinical / Non-Exempt

Summary :

Serve as a Care Coordinator Lead for the Health Homes Department.

Care Coordination services are provided to individuals referred by their Health Home or Managed Care provider as the result of one or more chronic health conditions. Services include Intensive Home Health Care Coordination, Low Level Care Coordination, Outreach and Screening, as well as completion of a Health Action Plan to assist individuals to receive care coordinated in a manner that will increase health plan compliance, improve health outcomes and reduce hospitalization.

Community Outreach responsibilities include maintaining on-going relationships with other community agencies that would refer to CRMHS for clinical services or would provide ancillary services to CRMHS clients. This includes individual and team meeting attendance as well as presentation to community groups including contract and governmental organizations as well as non-profit and health care clinics.

Essential Job Responsibilities :

Care Coordinator Lead Duties include but are not limited to :

  • Provide training and coaching to the team
  • Provide Assistant Manager and Program Director with regular updates related to coaching provided by the team lead
  • At least 75% of the times working in direct service of clients
  • Conduct monthly monitoring of project goals and outcomes
  • Collect and manage data for reporting and billing
  • Attend internal and external Lead meetings as required
  • MOC duties as assigned

The Care Coordinator Lead will work closely with contracted Health Homes and Health Plans to provide community-based services to improve overall health outcomes for individuals with a chronic health condition.

Services Provided by Care Coordinators include but are not limited to the following)

  • Initial contact and screening (to include several assessments) on all referred individuals utilizing appropriate tools and motivational interviewing techniques
  • Assistance to participants on navigating the healthcare system
  • Education on self-management health tools
  • Coaching for participant / family to ensure he / she / they understand(s) the Health Action Plan
  • Assistance to Participant / family on accessing community support groups and wellness education programs
  • Coordinating and mobilizing treating and / or authorizing entities
  • Actively managing referrals for services including when appropriate :
  • o Facilitating same-day services

    o Scheduling appointments on the Participant’s behalf

    o Arranging Participant transportation to appointments

    Community Outreach activities require organized and targeted contact with community partners. This includes marketing activities and coordination of care. Ability to create materials and presentations to individuals and groups regarding services available.

    Non-essential Job Functions :

  • Good communication and interpersonal skills,
  • basic knowledge of chronic mental illness, customer service, maintaining and building therapeutic relationships.
  • Assessment skills, multi-tasking, making decisions, problem solving, intermediate computer literate, and good time management skills.
  • Flexible and open to change.
  • Assist other members of the care coordination team with paperwork requirements. Serves as a backup support for other Care Coordinators.
  • Maintaining and updating active listing of resources.
  • Education, Licensing and Experience :

  • Approximately 1-2 years of experience in the social service field with mental illness or chemical dependency preferred.
  • Bachelor's degree in Social Work, related field (preferred)
  • Competencies, Knowledge, Skills and Abilities :

    Good communication and interpersonal skills, basic knowledge of chronic health conditions and mental illness, customer service, maintaining and building therapeutic relationships. Assessment skills, multi-tasking, making decisions, problem solving, intermediate computer literate, and good time management skills. Flexible and open to change.

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