The Care Coordinator
manages and arranges care activities on behalf of Enrollees to
facilitate the appropriate delivery of health care services and
improve health outcomes, including but not limited to organizing
care and facilitating communication across medical, behavioral
health, social, and pharmacy providers, agencies and supports
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:
- Works closely with treatment team to collaborate aftercare.
- Acts as liaison between the agency, enrollee and outpatient
providers, community resources and supports.
- Travels for home-based visits of enrollees.
- Assists clients in assessing appropriate resources, programs and
supports including completion of necessary paperwork.
- Facilitates education sessions, including health and wellness
coaching for individuals and groups.
- Documents in an electronic health record member’s information,
activities, care plans and services.
- Completes a Comprehensive Assessment and Care Plan for every
engaged member. Work with Primary Care Providers on Care Plan approval.
- Facilitates follow up calls.
- Participates with total staff to implement program objectives and philosophy.
- Attends meetings and trainings as required.