ACCS Discharge and Care Coordinator

Vinfen•Lowell, MA

4d•$27 - $27•Onsite

About The Position

The Adult CCS (A-CCS) Discharge and Care Coordinator provides case management, discharge planning, and care coordination services for adults receiving short-term community crisis stabilization services. This position plays a central role in helping persons served transition safety and successfully from the Adult CCS unit to the next appropriate level of car and community-based supports. The A-CCS Discharge and Care Coordinator works collaboratively with the multidisciplinary team, referral sources, outpatient and community providers, family members or natural supports when appropriate, and external service systems to identify discharge needs, reduce barriers to community stability, support safety planning and coordinate follow-up services. The role is primarily focused on case management, discharge planning and community linkage, while also contributing to crisis and safety planning throughout the person’s stay.

Requirements

Ability to work in a professional and confidential capacity.
Ability to engage adults experiencing behavioral health crises with empathy, respect and professionalism.
Ability to collaborate effectively as a member of a multidisciplinary team.
Ability to coordinate care across multiple systems, providers, and community agencies.
Ability to triage competing priorities and manage time effectively in a fast-paced crisis setting.
Ability to communicate clearly, both verbally and in writing.
Ability to establish supportive and trusting relationships with persons served and external partners.
Knowledge of person-centered, strengths-based, trauma-informed, and recovery-oriented practice.
Knowledge of crisis intervention and safety planning principles.
Knowledge of community behavioral health, substance use, medical, housing, entitlement, and social service resources for adults.
Knowledge of human, legal, and civil rights and the importance of self-advocacy and empowerment.
Sensitivity to cultural, religious, ethnic, disability, gender, sexual orientation, and socioeconomic differences.
Ability to work independently, use sound judgement, and problem-solve barriers to discharge and community placement.
Experience in behavioral health, crisis services, case management, discharge planning, substance use services, homeless services, or community -based human services.
Experience working with adults living with serious mental illness, substance use disorders, and co-occurring conditions.
Knowledge of local adult behavioral health and community resource systems.
Bilingual or bicultural applicants are encouraged to apply.
High school diploma or equivalent required.
A valid driver's license must be presented at the time of employment.
Incumbents must be able to pass a driver's screening background check.
CPR within 2 weeks of hire, First Aid within 2 weeks of hire

Nice To Haves

Bachelor’s degree in human services or related field preferred.
If driving, must maintain a safe driving record, which is subject to annual checks.
If using a personal vehicle, must possess and maintain adequate insurance.

Responsibilities

Coordinates discharge planning for adults admitted to the Adult CCS unit, beginning at admission and continuing throughout the person’s stay.
Completes psychosocial and practical needs screening related to discharge readiness, including housing, benefits, insurance, transportation, primary care, behavioral health treatment, substance use treatment, medications, legal issues, and other social determinants of health.
Identifies discharge barriers and develop person-centered plans to address them in collaboration with the person served and interdisciplinary team.
Coordinates referrals and linkages to community-based services, and supports, including outpatient behavioral health, psychiatry, primary care, substance use services, peer support, recovery programs, case management, shelters, housing resources, public benefits, and other social service agencies.
Schedules and confirms follow-up appointments as indicated prior to discharge.
Communicates and collaborates with hospitals, emergency departments, outpatient providers, community agencies, managed care entities, and other referral partners to support continuity of care.
Participates in daily multidisciplinary team meetings, case reviews, and discharge planning discussions.
Develops, reviews, and updates safety plans with persons served in collaboration with the clinical team.
Supports persons served in understanding treatment recommendations, discharge plans, available services, and next steps after leaving the program.
Engages family members, guardians, caregivers, or natural supports, when appropriate and with proper consent, to support stabilization and transition planning.
Provides information, education, and resource navigation to persons served regarding community services and recovery supports.
Advocates for persons served in accessing medically, behaviorally, and socially necessary services.
Maintains timely, accurate, and thorough documentation in the electronic health record, including referral activity, coordination efforts, discharge plans, safety planning, and follow-up arrangements.
Tracks referral outcomes, pending needs, and discharge-related tasks to ensure smooth transitions and minimize gaps in care.
Participates in utilization review, program quality initiatives, and data collection activities related to discharge planning and care coordination.
Maintains professional boundaries and practice in a manner that is person-centered, trauma-informed, recovery-oriented, culturally responsive, and strengths-based.
Performs other related duties as assigned.

Benefits

A fully funded, employer-sponsored retirement plan that requires no employee contribution as well as an employee-funded 403(b) plan
First-rate Medical, Dental and Vision plans that are open to all employees scheduled to work 30 hours per week or more.
Employer-paid Life, Accidental Death & Dismemberment and Long-Term Disability Insurance
Flexible Spending Accounts (Health and Dependent care)
Voluntary Term Life, Whole Life, Accident and Critical Illness Insurance
Voluntary Pet Insurance
15 days of Vacation per year
12 Paid Holidays per year
10 Sick Days per year
3 Personal Days per year
Up to $6,000 per year in Tuition Assistance
$500 Employee Referral Bonus with no annual cap!
Access to discounted movie and theme park tickets, online shopping discounts, and more!