Client Care Coordinator

Community Bridges, INC•Phoenix, AZ

12h•Onsite

About The Position

Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency in Arizona, providing residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing crisis, opioid use disorder, homelessness, and mental illness. CBI is a non-profit provider of substance use and behavioral health programs, including prevention, education, and treatment using evidence-based models. The Client Care Coordinator position is based at a shelter or temporary lodging site, primarily managing a housing caseload and coordinating care for individuals and families experiencing homelessness. This role involves providing coordination of care and support services to help individuals and families end their current episode of homelessness, especially those with complex substance use, mental health, housing, and medical care needs. The coordinator ensures connection to or coordination with existing Patient-Centered Medical Home (PCMH) or Primary Care Provider (PCP) services. The Client Care Coordinator acts as a bridge for individuals in shelter or temporary lodging, coordinating and monitoring community-based services (RBHA and Non-RBHA) and facilitating their delivery. This role focuses on individuals and families with the highest acuities and greatest vulnerabilities, coordinating care through the CBI Continuum of Care (or other community agency) to address social determinants of health through housing and community integration programs, such as crisis, urgent care, residential treatment, medical care, medication-assisted treatment, or outpatient behavioral health services. Once individuals are matched to housing, the coordinator uses housing search software to help identify units. The position also involves data entry into established systems for program outputs and outcomes, assisting higher-level personnel with reports, and completing end-of-shift reports documenting care coordination. The Client Care Coordinator works as part of a multi-disciplinary team including Patient Care Techs, Registered Nurses, Counselors, and Clinical Leads, and coordinates care with community providers and stakeholders. Documentation and tracking must adhere to Arizona Administrative Code (AAC), Arizona Department of Health Services/Department of Behavioral Health Services (ADHS/DBHS) Provider Manual, Commission on Accreditation of Rehabilitation Facilities (CARF), Community Bridges Policies and Procedures, and program-specific contract requirements.

Requirements

Highschool diploma or GED is required
Minimum of one (1) year of recovery from substance use and/or mental health disorders required
Minimum of six (6) months of paid related work experience where his or her prior experience would provide adequate exposure to both behavioral and medical crisis situations is required
Valid identification required
Will complete CBI Peer Certification within 90 days of being hired
Arizona Fingerprint Clearance card (program specific)

Nice To Haves

Associate degree (or higher) in a field related to Behavioral Health is preferred
1-3 years of full-time Health Care related work experience where his or her prior experience would provide adequate exposure to both behavioral and medical crisis situations is preferred

Responsibilities

Managing a housing caseload responsible for coordinating care for individuals and families who are experiencing homelessness
Providing coordination of care and support services to assist the individual or family with ending their current episode of homelessness
Ensuring coordination of care with existing PCMH, PCP or ensuring connection to new PCMH, PCP services occurs
Serving as the bridge for the individual(s) who are residing in shelter or temporary lodging by coordinating and monitoring RBHA and Non-RBHA community based services and facilitating delivery of these services
Working with individuals and families with the highest acuities and greatest vulnerabilities
Coordinating care through the CBI Continuum of Care (or other community agency as identified by client choice) on identified social determinants of health that can be addressed through housing and community integration programs
Utilizing the housing search software systems to help individuals identify units once an individual(s) is matched to housing
Completing data entry into established data system which assists with program outputs and outcomes
Assisting higher level personnel and leadership with ongoing reports
Completing an end of shift report documenting the coordination of care completed for each individual
Working as part of a multi-disciplinary team including specialty positions through the CBI continuum of care, such as, Patient Care Techs, Registered Nurses, Counselors and Clinical Leads
Serving as a nexus, coordinating care with community providers and stakeholders
Documenting and tracking required interactions according to the Arizona Administrative Code (AAC), Arizona Department of Health Services/Department of Behavioral Health Services (ADHS/DBHS) Provider Manual, Commission on Accreditation of Rehabilitation Facilities (CARF), Community Bridges Policies and Procedures, and specific for the program as specified by the program contract