Care Coordinator - Long Term Support Services

Venture Community Services • Uxbridge, MA

119d • $24

About The Position

Venture Community Services provides support to individuals facing diverse challenges through a compassionate and dedicated workforce using innovative practices that encourage independence, empowerment, and opportunity. The opportunity to enhance the lives of individuals with disabilities has untold rewards. At Venture, we are committed to empowering our employees through ongoing education and innovative training opportunities that cultivate talents. Venture Community Services offers an excellent benefits package, values work-life balance and promotes a culture of inclusion and equity where employees' opinions matter.

Requirements

• Bachelor's degree in health-related field preferred.
• High School Diploma/GED and/or applicable experience in community-based behavioral health support programs as a community health worker, peer specialist, or recovery coach may be substituted for degree.
• Valid driver's license with a reliable and appropriately insured vehicle required.
• Experience working with adults with developmental disabilities/geriatric population, experience with accessing local resources, navigating health, behavioral health, and/or substance abuse treatment systems, and excellent communication, documentation, time management, and organizational skills strongly preferred.

Responsibilities

• Participate in the development and implementation of program goals, objectives, and work plan tasks that are directed toward accomplishing the Mission and Vision of the CCHP.
• Perform outreach and engage with individuals who are eligible for the care management program within prescribed timelines.
• Provide information about the care management program including the benefits, requirements and program structure in a way that can be easily understood by the member.
• Schedule and conduct in-person assessments within prescribed timelines; maintain contact on a regular basis in accordance with contractual requirements and individual needs.
• Utilize person-centered framework to identify the enrollee's and/or caregiver's goals, preferences, desired level of involvement and address any cultural considerations or interpreter services needed.
• Coordinate access to services/fulfillment of integrated health needs with providers including Specialists, Primary Care Physician, Social Service Agencies and others as directed by the care plan.
• Interface with enrollee's referral agency, specialists, behavioral health, medical providers and other collaterals to gather information (including all existing medical, behavioral health and treatment plans) to create a comprehensive and person-centered Integrated Treatment Plan (ITP).
• Assist member in navigating the network of community based services and information.
• Coordinate communication between the member or designated representative and member's healthcare providers.
• Develop a schedule for follow-up and communication with enrollees in accordance with needs or contractual requirements.
• Assess progress against the care plan goals, work to continuously identify and resolve barriers; modify ITP as needed.
• Develop systems to assess the well-being of enrollees; implement outreach plan; provide crisis response to enrollees.
• Develop and maintain relationships with providers and community resources to ensure responsive, flexible services to meet the enrollee's needs.
• Ensure safe transitions in care for members moving between care settings including identifying and arranging necessary residential placement/at home supports.
• Secure outpatient appointments for individuals and facilitate home and community based services as necessary.
• Provide assistance with transportation to needed medical/behavioral health appointments.
• Attend, participate in, or facilitate meetings/trainings as assigned.
• Acquire and maintain all necessary trainings and certifications.
• Complete all required documentation in a timely manner.
• Perform other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Industry: Nursing and Residential Care Facilities
• Education Level: Bachelor's degree