Bilingual Health Home Integration Specialist

002 Sea Mar Community Health Center; Washington (District of Columbia); Hybrid; USD 52,000 - 62,000; Full time

Benefits offered by this job

Medical, Dental, Vision coverage

Long Term Disability

Employee Assistance Program (EAP)

Paid time off 24 days + 10 holidays

Job summary

Sea Mar Community Health Centers is seeking an Integration Specialist to provide Health Home services and care coordination for patients with complex medical, behavioral health, and social needs. You will meet patients in homes, communities, clinics, or inpatient settings, coordinating referrals and developing actionable Health Action Plans with measurable goals.

You will work with a multidisciplinary team to monitor progress, conduct screenings, and connect patients to internal Sea Mar services

Qualifications

• BSW or BA/BS in Human Services or related field.
• Experience in social service case management or care coordination.
• Experience with underserved populations and chronic conditions.

Responsibilities

• Provide six core Health Home services including health promotion and care coordination.
• Develop Health Action Plans (HAP) with patient goals.
• Coordinate with care team and community resources.
• Document all interactions in EHR and scheduling systems.

Skills

Bilingual English/Spanish

Education

BSW or BA/BS in Human Services

Tools

Microsoft Office

Electronic Health Records

Job description

Sea Mar Community Health Centers is seeking an Integration Specialist to provide Health Home services and care coordination for patients with complex medical, behavioral health, and social needs. You will meet patients in homes, communities, clinics, or inpatient settings, coordinating referrals and developing actionable Health Action Plans with measurable goals.

You will work with a multidisciplinary team to monitor progress, conduct screenings, and connect patients to internal Sea Mar services