Care Coordinator

Person Centered Services Care Coordination Organization, LLC; Village of Silver Creek (NY); Hybrid; USD 52,000 - 78,000; Full time

Benefits offered by this job

PTO 20 days (first year)

PTO 25 days (second year)

13 paid holidays

Health insurance (Medical, Dental &amp

Vision)

401(k) with company match (50% up to 3

Job summary

Person Centered Services is seeking a Care Coordinator to oversee health and behavioral healthcare coordination across Silver Creek and surrounding towns. The role requires travel to client homes, clinics, and community sites to implement comprehensive, person-centered life plans with the support network.

The position offers a hybrid schedule with on-site orientation in West Seneca, NY and flexible remote work where appropriate, plus robust benefits, professional development, and a commitment to

Qualifications

• Bachelor’s degree with 2 years relevant experience OR a Licensed Registered Nurse with 2 years relevant experience OR a Master’s degree with 1-year relevant experience required.
• A valid New York State driver’s license is required. If residing in a bordering state, a valid driver’s license from that state is acceptable for employment in New York.

Responsibilities

• Completes required assessments using person centered planning techniques and gathers relevant assessments.
• Develops a comprehensive, person-centered Life Plan with the individual and their circle of support.
• Gathers and reviews Life Plan with the interdisciplinary team at least annually and after life-changing events.
• Coordinates all aspects of an individual’s care.
• Travels to meet individuals in homes, physician offices, and community settings.
• Collaborates with providers and service support team members.
• Maintains documentation and compliance for case files and reports.

Skills

Person-centered planning

Motivational interviewing

SMART goals

Communication skills

Cultural competence

Confidentiality rules

Time management

Organizational skills

Education

Bachelor’s degree

Licensed Registered Nurse

Master’s degree

Tools

Health Information Technology

Job description

Why Work For Person Centered Services?

When you join the Person Centered Services team, you can make a difference in the lives of people with intellectual and developmental disabilities, while also reaching your own career goals.

Benefits For Full-time Positions Include

• 20 Days of paid time off (PTO) in your first year! Increasing to 25 Days in your second year!
• 13 Paid Holidays
• Comprehensive health insurance plans for you to choose what best fits your needs (Medical, Dental & Vision)
• 401(k) - the Company matches 50% of the first 6% up to a maximum of 3%
• Company paid benefits: basic life insurance, long-term disability, and a Lifestyle Spending Account with a benefit of up to $500 set aside for employees to spend on wellness eligible expenses!
• Employee Discount and Wellness Programs - Currently providing 3 paid hours per week for exercise, volunteering or personal wellness!
• Professional development opportunities including mentorship program options and ongoing coaching

New Employee Orientation (NEO)

• All new team members participate in NEO offered Monday - Friday both onsite and online.
• Day one includes in-person training at our West Seneca, NY office, where new team members are introduced to our culture, values, and the foundations of Care Coordination.

Hybrid Schedule

• Care Coordinators are required to attend three onsite days per week during the first 90 days to support on boarding and integration
• After successfully completing this period, team members may transition to a hybrid schedule for added flexibility. Supervisors may extend the on-site requirement if needed.

Care Coordinator: HYBRID

Job Summary

This caseload is located in the surrounding areas of Silver Creek, Dunkirk, Fredonia, South Dayton, Forestville, Stockton, and Mayville.

Required

The care coordinator has an overall responsibility and accountability for coordinating all aspects of the individual’s care, including but not limited to health and behavioral healthcare, community supports, and other services required to meet the needs of the individual. For individuals who are enrolled in the health home, the care coordinator will take a holistic approach to care by utilizing the core standards of service. These include:

• Comprehensive Care Management
• Care Coordination and Health Promotion
• Comprehensive Transitional Care
• Individual and Family Support
• Referral to Community and Social Support Services
• Use of Health Information Technology (HIT) to Link Services

Essential Functions

• Completes required assessments using person centered planning techniques, as well as gathers and incorporates all other relevant assessments.
• Develops a comprehensive, person-centered Life Plan with the individual and their circle of support, as well as their entire service provider team.
• Supports the individual in the planning process to ensure that the individual directs the process to the maximum extent possible and can make informed decisions and choices.
• Reviews the Life Plan with the individual’s entire interdisciplinary team no less than annually, and every time there is a life changing event. This review must occur during a face-to-face meeting, no less than annually.
• Accountable for coordinating all aspects of an individual’s care.
• Effectively manage a tiered caseload, while tailoring services to individual needs.
• Completes program enrollment and eligibility document.
• Completes and secures consents and authorizations to share information.
• Develops and maintains appropriate records.
• Completes and reviews paperwork necessary for case files and reports.
• Completes documentation and billing in a timely manner.
• Frequent travel meeting with individuals in their homes, physician/provider offices, and other public places in order to conduct assessments and provide services.
• Accompanies individuals to appointments in accordance with Person Centered Services policy.
• Collaborates with providers and service support team members.
• Initiate incident reports and follow-up to ensure compliance with regulations.
• Monitors individual satisfaction with supports and services.
• Ensures case files are in compliance with regulation and policy.
• Provide quality driven, cost effective, culturally appropriate services.

Other Duties

• Commits to a respectful, just, and supportive environment for individuals and team members aligning with the company’s commitment to diversity, equity, inclusion and belonging.
• Other duties as necessary or assigned.

Knowledge, Skills & Abilities

• Knowledge of developmental disabilities, chronic disease, and social determinants of health.
• Strong knowledge of OPWDD funded services and supports.
• Experience with motivational interviewing.
• Experience writing SMART goals.
• Knowledge of person-centered planning regulations.
• Ability to build relationships and effectively communicate.
• Encourages community integration.
• Demonstrates cultural competence.
• Demonstrates ethical and professional responsibilities and boundaries.
• Demonstrates capacity to use Health Information Technology to link services and facilitate communication.
• Knowledge of confidentiality regulations.
• Organizational and time management skills
• Ability to prioritize.
• Proactively approaches professional responsibilities.
• Completes work in a timely manner

Education & Experience

• Bachelor’s degree with 2 years relevant experience OR a Licensed Registered Nurse with 2 years relevant experience OR A Master’s degree with 1-year relevant experience required.
• A valid New York State driver’s license is required. If residing in a bordering state, a valid driver’s license from that state is acceptable for employment in New York.

Person Centered Services has a commitment to equal employment opportunity for all staff and applicants for employment. Employment decisions including, but not limited to, those such as staff selection, performance evaluation, administration of benefits, working conditions, staff programs, transfers, position changes, training, disciplinary action, compensation, and separations are made without regard to race, color, religion (including religious dress and grooming), creed, national origin, nationality, citizenship status, domestic partnership status, ancestry, gender, affectional or sexual orientation, gender identity or expression, marital status, civil union status, family status, age, mental or physical disability (including AIDS or HIV-related status), atypical hereditary cellular or blood trait of an individual, genetic information or refusal to submit to a genetic test or make available the results of a genetic test, military status, veteran status, or any other characteristic protected by applicable federal, state, or local laws.