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Our Future Begins With You
Our Future Begins With You

As a health care organization, Lahey Hospital and Medical Center is committed to providing high quality, safe patient care. As an employer, Lahey is committed to ensuring a professional environment where every staff member is encouraged to excel. green decorative barWith a team approach to care, physicians and nurses at Lahey work side-by-side with allied health professionals, medical technologists, and administrative and support staff to deliver on our mission. Lahey encourages learning and growth at all levels, and we offer competitive salaries and benefits.

Case Coordinator, Here For You

Job ID 145152 Date posted 10/17/2017
Job Description

The Care Coordinator is the single point of contact for the integrated, seamless and person-centered service in support of Intensive Community Care Support (ICCS) Enrollees. The Care Coordinator, under the direction of the LHBS Program Manager for ICCS, implements and monitors enrollee adherence and response to the Care Coordination Plan (CCP).

? Assume responsibility for a mixed acuity case load;

? Collaborate with Beacon ICCS Clinician and NHP Care Manager, as indicated

? Facilitate consents, gathering of clinical information (including all existing medical, behavioral health and treatment plans) and discussion with enrollee?s BH and medical providers, to draft the initial Care Coordination Plan (CCP);

? Conduct engagement activities and provide information about the ICCS program and benefit

? Facilitate the scheduling of and conduct the needs assessment, face-to-face whenever possible and appropriate;

? Identify need for interpreter service, cultural considerations, preferences, and accommodations;

? Utilize person-centered framework to identify the enrollee?s and/or caregivers goals, preferences, and desired level of involvement;

? Develop and maintain crisis plans and communicate the individual?s self-management plan

? Coordinate access to services and fulfillment of integrated health needs including medical appointments as directed by the CCP;

? Continuously identify and help resolve barriers to meeting goals and complying with the CCP;

? Facilitate enrollee referrals to resources and an ongoing follow-up process to determine whether an enrollee acted upon referrals;

? Develop a schedule for follow-up and communication with the enrollee;

? Assess progress against the CCP and goals and update at intervals as determined by risk stratification,

? Ensure that all participating providers and supports receive the CCP as it is updated, including NHP/Beacon staff;

? Secure outpatient appointments for the enrollee and facilitation of home and community based services;

? Assist enrollee in navigating the network of community based services and information;

? Support safe transitions in care for enrollees moving between settings;

? Provide temporary assistance with transportation to needed medical/BH appointments when needed while transitioning to community-based transportation, (e.g., assisting enrollee with the PT1 form).

? Facilitate communication between the enrollee or designated representative and enrollee?s healthcare providers;

? Attend integrated rounds meeting as scheduled or as requested;

? Participate in weekly supervision with LHBS ICCS Program Manager;

? Participate in all trainings conducted or directed by LHBS, Beacon and NHP;

? Provide self-management, CCP and other materials in preferred language and
formats when needed;

? Support enrollee with medication referrals and management

? Ensure enrollee screening of medical conditions, identification of medical PCP, and connection to medical provider(s) as needed.

-Bachelor's Degree from an accredited university in psychology, social work or related human services field

-3-5 years? experience in community-based behavioral health support program.

-Candidate may be a licensed clinician who does not have the credentials to practice independently (e.g., LPN, LSW, or degree in a related health care field).

-Strong communication skills (both written and verbal)

-Strong time management and organization skills

-Must demonstrate good boundaries regarding confidentiality and personal relationships

-Strong ability to evaluate what is needed by each individual and adjust approach accordingly.

-Strong problem solving ability and analytical skills

-Experience with accessing local resources and navigating mental health and/or substance abuse treatment systems.

-Ability to utilize computers, web-based applications, and MS Office application

Days Scheduled Hours 40 hours, full time
Physical Requirements

Must be able and willing to transport enrollees served. As such, must have a valid driver's license, good driving record, and reliable vehicle. Travel and an ability to meet persons served in a variety of outreach settings is required. Some flexible hours to accomplish outreach and engagement of enrollees at times when they are reachable; this may involve some early evening hours or later work days.