Care Coordinator

Advocates; Worcester (MA); On-site; USD 42,000 - 50,000; Full time

Job summary

Advocates seeks a dedicated Care Coordinator to provide care management services to adults in need, delivering telephonic, virtual, and in-person support to navigate health care systems and connect with resources.

The role emphasizes advocacy, patient autonomy, and collaboration with the Integrated Care Team to assess needs, develop individualized plans, and promote safety and well-being within a community-based setting.

Qualifications

• High school diploma or equivalent.
• 1-2 years of work experience in related behavioral health, human services, and/or medical field.
• Ability to use an Electronic Health Record to document medical necessary clinical services.
• Excellent written and verbal communication skills.
• Knowledge of motivational interviewing techniques to help individuals identify strengths, set goals, and develop hope for the future.
• Ability to thrive in a fast-paced, team environment.

Responsibilities

• The care coordinator serves as the primary point of contact for all individuals served on caseload.
• Provide telephonic, virtual (video), and in-person support and guidance to individuals served, including but not limited to helping them navigate health care systems, and connecting them with relevant resources.
• Identify individuals in need and evaluate their specific circumstances and challenges through regular outreach and engagement, building trust and rapport to connect them with needed resources.
• Act as a strong advocate for individuals served, ensuring their voices are heard, their needs are met, and empowering them to make informed decisions about their care while promoting autonomy and self-determination.
• Identify individuals served safety issues and take appropriate measures to ensure safety and well-being in consultation with program leadership.
• Work collaboratively with the individual's Integrated Care Team, including primary care providers, behavioral health providers, and others as indicated.
• Respond to individuals served and stakeholder requests and make timely referrals to other services and resources as needed.
• Collaborate with the members to generate individualized care plans based on assessed needs
• Along with members of the care team, work to reduce individuals served utilization of higher levels of care when appropriate, and support members’ transitions from inpatient settings back into the community
• Work collaboratively and effectively with the individual receiving services and care management team to help members identify community resources, build and maintain strong relationships and develop natural supports in the community.
• Ensure accurate and timely documentation to ensure program/contractual deliverables are met and continuity of care is maintained, in accordance with Advocates and One Care policies and funder contract requirements
• Attend and actively participate in weekly supervision, team meetings and any stakeholder meetings.
• Schedule and participate in assessments in a timely manner to meet contractual needs. through supervisory channels or by following the Hate, Discriminatory, or Oppressive Behavior (HDOB) reporting protocol.
• Perform all duties in accordance with agency policies, procedures, and performance standards
• Strictly follow all agency Performance Standards outlined in the Employee Handbook.
• Perform other duties as assigned.

Skills

Communication skills

Motivational interviewing

Organizational skills

Cultural competency

Bilingual Spanish

Education

High School Diploma / GED

1-2 years experience in related field

Tools

Electronic Health Record (EHR)

Job description

Overview

Starting Rate: $20.00 - $24.00/hour

Schedule: Monday through Friday 8am - 4pm or 9am - 5pm

The Care Coordinator will provide care management services to adults in need of services.

Who We Are

At Advocates, we provide comprehensive services for people facing developmental, mental health, or other life challenges.

We’rea nonprofit, mission-driven organization with a person-centered approach, empowering the individuals we support to make choices, build independence, and live full, meaningful lives. Our work is rooted in respect, compassion, and inclusion, and we envision a world where individual differences are appreciated and celebrated.

At Advocates, we value the ideas, experiences, and contributions of employees and are committed to fostering a supportive, welcoming culture where everyone can grow and thrive.

Minimum Education Required

High School Diploma/GED

Additional Shift Details

ability to meet members in the community

Responsibilities

• The care coordinator serves as the primary point of contact for all individuals served on caseload.
• Provide telephonic, virtual (video), and in-person support and guidance to individuals served, including but not limited to helping them navigate health care systems, and connecting them with relevant resources.
• Identify individuals in need and evaluate their specific circumstances and challenges through regular outreach and engagement, building trust and rapport to connect them with needed resources.
• Act as a strong advocate for individuals served, ensuring their voices are heard, their needs are met, and empowering them to make informed decisions about their care while promoting autonomy and self-determination.
• Identify individuals served safety issues and take appropriate measures to ensure safety and well-being in consultation with program leadership.
• Work collaboratively with the individual's Integrated Care Team, including primary care providers, behavioral health providers, and others as indicated.
• Respond to individuals served and stakeholder requests and make timely referrals to other services and resources as needed.
• Collaborate with the members to generate individualized care plans based on assessed needs
• Along with members of the care team, work to reduce individuals served utilization of higher levels of care when appropriate, and support members’ transitions from inpatient settings back into the community
• Work collaboratively and effectively with the individual receiving services and care management team to help members identify community resources, build and maintain strong relationships and develop natural supports in the community.
• Ensure accurate and timely documentation to ensure program/contractual deliverables are met and continuity of care is maintained, in accordance with Advocates and One Care policies and funder contract requirements
• Attend and actively participate in weekly supervision, team meetings and any stakeholder meetings.
• Schedule and participate in assessments in a timely manner to meet contractual needs. through supervisory channels or by following the Hate, Discriminatory, or Oppressive Behavior (HDOB) reporting protocol.
• Perform all duties in accordance with agency policies, procedures, and performance standards
• Strictly follow all agency Performance Standards outlined in the Employee Handbook.
• Perform other duties as assigned.

Qualifications

• High school diploma or equivalent.
• 1-2 years of work experience in related behavioral health, human services, and/or medical field required
• Ability to use an Electronic Health Record to document medical necessary clinical services.
• Excellent written and verbal communication skills.
• Treats all individuals served with respect and upholds their dignity throughout the service delivery process.
• Knowledge of and ability to utilize motivational interviewing techniques to help individuals identify strengths, set goals, and develop hope for the future.
• Ability to thrive in a fast-paced, team environment.
• Strong organizational skills and ability to think creatively.
• Must hold a valid driver's license, have access to an operational and insured vehicle to meet program requirements including but not limited to attending in person member assessments in the community.
• Strongly prefer a candidate that will have a demonstrated understanding of and competence in serving culturally diverse populations.
• Bilingual in Spanish prefered

Advocates is committed to cultivating a diverse and welcoming community where everyone feels respected and valued. Advocates fosters a culture of inclusion that celebrates and promotes diversity along multiple dimensions, including race, ethnicity, sex, gender identity, gender expression, sexual orientation, partnered status, age, national origin, socioeconomic status, religion, ability, culture, and experience.

We are committed to providing equal employment opportunities to all applicants. If you require a reasonable accommodation during the application, interview or hiring process, please contact Human Resources.