Care Coordinator Community

Good Shepherd Services•Bronx, NY

13d•Hybrid

About The Position

We are seeking a dedicated and compassionate Bilingual (Spanish-speaking) Care Coordinator to support youth enrolled in our Health Home program. The Care Coordinator guides participants and their legal guardians through the health care system by addressing access barriers, building relationships with service providers, and monitoring interventions and outcomes to ensure high-quality care coordination. The position reports to the Care Manager Supervisor, Health Services, and is based at 685 E. 187th Street, Bronx, NY 10458. Staff are expected to be on-site as requested; hybrid schedules may be provided based on program needs and leadership discretion. The role is 35 hours and non-exempt. Education and credential requirements are determined by the acuity level of the children served and may require a Bachelor of Arts or Science degree with two years of experience. The position requires relevant experience serving children and families across child welfare, developmental disabilities, mental health, healthcare, or other systems, including preventive services. Additional experience, education, or training may be required for care coordination of high-acuity enrollees; extensive experience coordinating care is required for children with medical fragility.

Requirements

A Bachelor of Arts or Science degree with two years of experience is required for applicable education and credential requirements, which are determined by the acuity level of children served.
Previous experience as a Case Planner, Care Coordinator, Case Manager, and/or Case Worker in a social service setting.
Relevant expertise and experience serving children and families in child welfare, developmental disabilities, mental health, healthcare, and/or other systems, including preventive services.
Experience providing service coordination and information, linkages, and referrals for community-based services.
Care Coordinators serving high-acuity enrollees must demonstrate knowledge and understanding of the needs of those children and their families, evidenced by additional years of experience, education, or training.
Care Coordinators assigned to children with medical fragility must have extensive experience coordinating their care.

Nice To Haves

Bilingual Spanish/English speaking candidates are highly encouraged to apply.
Experience with Child Welfare, ACS, and Foster Care is helpful.

Responsibilities

Secure required Care Management enrollment consents from individuals or their legal guardians.
Conduct initial and ongoing comprehensive Child and Adolescent Needs and Strengths (CANS) assessments to determine the appropriate level of care management.
Oversee development, implementation, and ongoing management of each Individualized Plan of Care (IPC).
Coordinate services according to the enrollee’s acuity level and reinforce treatment recommendations.
Continuously monitor and evaluate needs across prevention, wellness, medical care, behavioral health, care transitions, and social and community services.
Meet client contact requirements, including required face-to-face visits for child-serving Care Managers according to each individual’s acuity level.
Complete Care Management documentation accurately and within required timeframes using the designated Care Management Portal (MAPP) and Electronic Health Records (EHRs), as appropriate.
Advocate for clients within the agency and with external service providers.
Connect enrollees with appropriate wellness and prevention resources based on their needs and preferences.
Educate children and caregivers about chronic condition management, immunizations, screenings, and other preventive health interventions.
Assist clients in obtaining and maintaining public benefits and supports, including Medicaid, cash assistance, Social Security, SNAP, housing supports, legal services, and employment or training programs.
Communicate with individuals, families, and caregivers with sensitivity to language, literacy, and cultural preferences.
Facilitate care planning meetings and participate in the interdisciplinary team to support comprehensive, coordinated care.
Identify community-based resources and manage service referrals, access, engagement, follow-up, and coordination.
Participate in hospital discharge planning to ensure recommended post-discharge services are arranged before release.
Attend and participate in ongoing staff development and training.
Ensure children receive periodic dental, vision, and hearing evaluations and follow-up treatment in accordance with Medicaid EPSDT guidelines.
Perform other duties as assigned.