Care Coordinator

North Homes Children & Family Services; Bemidji (MN); On-site; USD 42,000 - 54,000; Full time

Job summary

North Homes Children & Family Services seeks a Care Coordinator to connect clients with behavioral health and SUD treatment services in Bemidji, MN. You will support coordination across SUD programs, assist with intake, and collaborate with clinicians to promote continuous, person-centered care.

The role emphasizes addressing social determinants of health, coordinating referrals, and maintaining HIPAA-compliant documentation in an integrated care setting.

Qualifications

• Minimum Qualifications: High school diploma or GED; respectfully provide person-centered, nonjudgmental services.
• Ability to complete DHS background study and meet employment requirements.
• Must be at least 21 years old and possess a valid Minnesota driver’s license when driving is required.
• Ability to maintain confidentiality and follow privacy and professional standards.

Responsibilities

• Provide care coordination with emphasis on SUD programs and support to other programs as needed.
• Assess client needs through intake, screening, and ongoing coordination.
• Connect clients with treatment services, resources, and support networks.
• Collaborate with SUD providers and mental health professionals to promote continuity of care.
• Coordinate referrals, track outcomes, and ensure timely access to services.
• Assist with transitions between levels of care and discharge planning.
• Maintain accurate documentation in the EHR and HIPAA compliant records.

Skills

Client-centered care

Interpersonal skills

Communication

Time management

Team collaboration

Education

High school diploma or GED

Tools

Electronic Health Record (EHR) systems

Job description

Description

Join our team as a Care Coordinator and make a meaningful difference in helping individuals and families navigate behavioral health and substance use disorder services!

The Care Coordinator plays an essential role in connecting clients with appropriate treatment, resources, and support services while promoting continuity of care across the organization. This position will provide significant support to our Substance Use Disorder (SUD) programs, working closely with treatment providers, clients, families, and community partners to coordinate services, address barriers to care, and support positive treatment and recovery outcomes.

While the primary emphasis of this position will be supporting SUD programming, the Care Coordinator will also assist other organizational programs as needed, helping ensure individuals receive comprehensive, person-centered, and coordinated care.

Duties and Responsibilities

Responsibilities include, but are not limited to:

• Provide comprehensive care coordination support, with a primary emphasis on the organization's Substance Use Disorder programs and additional support to other programs as needed.
• Assess client needs through intake, preliminary screening, and ongoing coordination activities.
• Connect clients and families with appropriate treatment services, community resources, and support systems.
• Work collaboratively with SUD treatment providers, mental health professionals, and other team members to promote continuity of care and successful treatment outcomes.
• Facilitate internal and external collaboration to support person-centered and family-centered integrated treatment planning.
• Assist clients in identifying and addressing Social Determinants of Health (SDOH), including housing, transportation, employment, healthcare, and other barriers to treatment and recovery.
• Coordinate internal and external referrals, track referral outcomes, and follow up to ensure timely access to appropriate services.
• When appropriately qualified and authorized, provide SUD Treatment Coordination services in accordance with Minnesota requirements, including service coordination, documentation, and applicable billing standards.
• Assist clients with transitions between levels of care, including admission to treatment, discharge planning, and connection to ongoing recovery support services.
• Participate in the rotation of intake responsibilities for new client inquiries and referrals.
• Assist clients with updating intake documentation, releases of information (ROIs), and other required paperwork on an annual basis or as needed.
• Document and maintain accurate, timely, and complete care coordination summaries and service records.
• Assist assigned providers with client scheduling, caseload coordination, and obtaining or disclosing records for care coordination purposes in accordance with applicable confidentiality requirements.
• Track and monitor referrals, service utilization, and follow-up activities.
• Attend integrated multidisciplinary team meetings and document meeting notes, attendance, and follow-up activities.
• Monitor Encounter Alert Service (EAS) notifications and follow up with clients within 24 hours of emergency department or hospital discharge, as appropriate.
• Collect and enter required information into the client's Electronic Health Record (EHR).
• Assist with monitoring provider caseload assignments and coordinating client access to services.
• Collaborate with SUD program leadership and other organizational departments to identify opportunities for improved coordination, access, and service delivery.
• Maintain compliance with HIPAA, applicable substance use disorder confidentiality requirements, organizational policies, and relevant state and federal regulations.
• Perform other duties as assigned by the supervisor.

Requirements

Minimum Qualifications

• High school diploma or GED.
• Demonstrated ability to provide respectful, compassionate, person-centered, and nonjudgmental services to individuals from diverse backgrounds.
• Ability to successfully complete a Minnesota Department of Human Services (DHS) background study and meet applicable employment requirements.
• Must be at least 21 years of age.
• Valid Minnesota driver's license, when driving is required for assigned responsibilities.
• Ability to work collaboratively with individuals, families, providers, and community agencies.
• Ability to maintain confidentiality and adhere to applicable privacy and professional standards.

Preferred Qualifications and Experience

• Previous experience providing Substance Use Disorder Treatment Coordination services in Minnesota.
• Education, training, and professional experience that meet Minnesota's applicable qualifications for providing and billing SUD Treatment Coordination services.
• Two years of postsecondary education in healthcare, human services, behavioral health, or a related field; or three years of relevant experience, preferably within a behavioral health clinic, SUD treatment program, or social services setting.
• Experience and knowledge of behavioral health and substance use disorder programming, including integrated treatment approaches.
• Familiarity with Minnesota SUD treatment services, regulatory requirements, service documentation, and reimbursement practices.
• Experience working with individuals who have co-occurring mental health and substance use disorders.
• Experience coordinating services across multidisciplinary treatment teams and community-based organizations.
• Knowledge of community resources, recovery support services, and social determinants of health.

Skills, Knowledge, and Abilities

• Excellent client-centered care, interpersonal, and organizational skills.
• Ability to manage multiple responsibilities and competing priorities in a fast-paced environment.
• Strong oral and written communication skills.
• Ability to work independently and collaboratively as part of an interdisciplinary team.
• Ability to exercise sound judgment in emotionally demanding or challenging situations.
• Knowledge of community resources and support services available to individuals and families.
• Ability to adapt to changing program needs, client circumstances, and organizational priorities.
• Proficiency in using Electronic Health Record (EHR) systems and maintaining accurate service documentation.
• Demonstrated compassion, empathy, and understanding when supporting individuals and families.
• Ability to professionally collaborate with internal and external providers, community organizations, and referral agencies.
• Understanding of confidentiality requirements and professional boundaries.
• Commitment to providing inclusive, culturally responsive, and nonjudgmental services.

Physical Requirements

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.
• Ability to perform the essential functions of the position, with or without reasonable accommodation.