Care Coordinator

Integrea Community Mental Health System; Opelika (AL); On-site; USD 42,000 - 54,000; Full time

Job summary

Integrea Community Mental Health System in Alabama is seeking a Care Coordinator to coordinate and integrate behavioral health, primary care, substance use treatment, social services, and community supports for individuals served. This is an office-based, full-time role focused on seamless, person-centered care that promotes recovery and wellness.

You will collaborate with clients, families, treatment teams, hospitals, and community partners to ensure smooth transitions, timely follow-ups, and

Qualifications

• Coordinate behavioral health, primary care, SUD treatment and social services for assigned individuals.
• Develop and update individualized care plans with clients and families.
• Facilitate communication among providers to ensure continuity of care.
• Support transitions between levels of care, including hospitals and detox programs.
• Document care activities and ensure HIPAA compliance.

Responsibilities

• Establish therapeutic relationships and promote recovery.
• Advocate for clients’ needs across healthcare and social services.
• Maintain active partnerships with health centers and community agencies.
• Track referrals, outcomes, and follow-up activities.
• Participate in quality improvement to improve care coordination.

Job description

At Integrea Community Mental Health System, you’re not just joining a workplace—you’re joining a mission‑driven team that cares deeply about its consumers, its community, and each other. We invest in our employees with comprehensive benefits—including Blue Cross/Blue Shield health and dental, vision and supplemental insurance options, the security of participating in the Retirement Systems of Alabama (RSA) and guaranteed 40‑hour workweeks for full‑time staff.

This position will be based in Lee County and serve Tallapoosa County and Chambers County.

Position Summary:

The Care Coordinator is responsible for coordinating and integrating behavioral health, physical health, substance use disorder treatment, social services, and community-based supports for individuals served by Integrea. The Care Coordinator works collaboratively with clients, families, treatment teams, healthcare providers, hospitals, community agencies, and payers to ensure seamless, person-centered, trauma-informed care that improves health outcomes and supports recovery and wellness. Care coordination is intended to ensure individuals successfully navigate complex systems of care. It is an office-based position.

Key Responsibilities:

Care Coordination & Service Integration

• Coordinate behavioral health, primary care, substance use disorder treatment, and social support services for assigned individuals.
• Develop, monitor, and update individualized care coordination plans in collaboration with the person served, family members, and interdisciplinary treatment team.
• Facilitate communication among internal and external providers to ensure continuity of care.
• Support transitions between levels of care, including inpatient psychiatric facilities, emergency departments, residential treatment programs, detoxification programs, and community settings.
• Ensure timely follow-up after hospitalization, crisis intervention, or other significant treatment events.
• Participate in multidisciplinary treatment team meetings and case conferences.

Client Engagement & Advocacy

• Establish therapeutic and supportive relationships with individuals receiving services.
• Promote client self-determination, recovery, resilience, and wellness.
• Assist individuals in overcoming barriers to care, including transportation, housing, insurance, employment, and access to benefits.
• Educate clients and families regarding available services and community resources.
• Advocate for the needs and preferences of individuals across healthcare and social service systems.

Community Collaboration

• Maintain active partnerships with healthcare providers, hospitals, federally qualified health centers (FQHCs), social service agencies, schools, child welfare agencies, criminal justice agencies, and other community organizations.
• Facilitate referrals and track outcomes to ensure services are received.
• Support outreach and engagement activities for individuals at risk of disengaging from treatment.

Documentation & Compliance

• Complete all required clinical and administrative documentation within established timeframes.
• Maintain accurate records in the Electronic Health Record (EHR).
• Track referrals, care transitions, and follow-up activities.
• Ensure compliance with the CCBHC model, organizational policies, HIPAA requirements, payer requirements, and applicable federal and state regulations.

Quality Improvement

• Participate in quality improvement initiatives related to care coordination and health outcomes.
• Monitor performance indicators and assist in achieving CCBHC model quality benchmarks.
• Utilize data and population health tools to identify service gaps and improve care management processes.
• All other duties as assigned.