Senior Care Coordinator - Community Prevention and Treatment Services (Req 101094)

Whitney M Young Jr Health Center•Albany, NY

2h•$24 - $26

About The Position

The Senior Care Coordinator is responsible for performing specialty retention and adherence-specific care coordination services. This role involves conducting comprehensive screenings/assessments and enhanced service planning to improve the health and well-being of people living with HIV/AIDS (PLWHA). The goal is to reduce viral load while supporting PLWHA in independently managing their healthcare. This includes addressing the medical, behavioral health, community services, and social determinants of health for participants with the highest needs, such as those newly diagnosed with HIV, starting antiretroviral medications for the first time, or experiencing difficulties adhering to the program due to life events or barriers to care. The Senior Care Coordinator is a member of the multi-disciplinary team, assisting in training care managers and linkage/peer support staff, and maintaining relationships with external community-based agencies.

Requirements

Bachelor’s degree in Psychology, Sociology, Social Work, or Nursing.
Two (2) years’ work experience in case management/care coordination with one of the following populations: persons with HIV/AIDS, HCV, women, children & families, persons with MR/DD, or persons with mental health or substance use disorders
Strong written and verbal communication skills
Provides excellent customer service and demonstrates a high level of cultural competency, professionalism and flexibility.
Ability to adhere to strict confidentiality guidelines.
Experienced with public speaking, group training.
Have a working knowledge of computers and Microsoft Office program.
Employees must have a clean license and valid driver’s license which will be verified annually.
Proof of adequate auto insurance is required in compliance with NYS mandatory limits and coverage.

Nice To Haves

Bilingual (English/Spanish).
Experience with New York State Department of Health AIDS Institute Reporting Software

Responsibilities

Manages oversight for care coordination activities for specialty retention and adherence specific caseload
Conducts outreach and engagement for assigned program participants
Develops enhanced service plans to address the medical, mental health, substance use and social services needs for program participants.
Maintains assigned caseload of patients in all phases of case management and maintains a productivity rate as established by Supervisor
Assists patients to achieve outcomes as required by NYSDOH, The AIDS Institute and other regulatory bodies
Provides training to staff to ensure that they have full knowledge of the functions of their position(s).
Identifies and maintains relationships with community based organizations for referrals and linkages.
Conducts outreach, education and consultation to community based organizations about the services provided to foster strong relationships.
Enters data accurately on the web-based reporting system(s) and electronic medical record
Assists Data analyst and Program Manager with monthly reports as well as yearly reports as needed.
Monitors patients treatment and medication adherent as well authorizations for medications
Ensures that all documentation is completed that meet regulatory, funding and agency requirements including assessments; notes; care/service/treatment plans; Conducts face-to-face Intakes And assessments in the community on program site or at home visits.
Demonstrates knowledge of development across the lifespan, cultural and linguistic norms of minority populations and subpopulations, and awareness of socioeconomic health disparities as it pertains to medical, mental health, and substance use treatment.
Provides education, encourages retention in care, adherence to medical treatment, and strategies for promoting chronic disease self-management.
Manages referrals to appropriate agencies required to assist the client in achieving the goals and objectives identified in the Care/Treatment/Service Plan.
Participates in multidisciplinary team meetings, case conferences and any service planning meetings to ensure patients are receiving the best care possible
Assists clients to access programs that will help pay for medical care and prescriptions.
Oversees transfers, inactivation, and discharge processes.
Ensures timely documentation in the electronic health record and in designated State and/or Federal data management systems.
Participates in Performance Improvement/Continuous Quality Improvement activities, as assigned.
Demonstrates excellence in both internal and external customer service.
Understands and effectively communicates HIPAA compliance, corporate compliance and client confidentiality.
Ensures and/or remains in compliance with local, state, and federal regulation, i.e. NCQA, Joint commission, NYS Department of Health, HRSA
Adheres to the National Patient Safety Goals as defined by NCQA and the Whitney M. Young Jr. Health Services.
Completes other duties as assigned.