Care Coordinator I, Integration, Enhanced Care Management

Socket.dev; Oakland (CA); On-site; USD 80,603,000 - 95,046,000; Full time

Benefits offered by this job

Competitive salaries

PTO / Sick leave

403(b) retirement plan

Medical / vision / dental

Job summary

Native American Health Center in Oakland, CA is seeking a Care Coordinator I for Integration – Enhanced Care Management. The role involves coordinating care across providers, guiding members through treatments, and ensuring access to a holistic care system.

The position is full-time, non-exempt, and requires bilingual capabilities and a CA driver’s license. Responsibilities include managing diverse caseloads, conducting assessments, developing care plans, and maintaining compliance with HIPAA

Qualifications

• High school diploma or GED required.
• Fluency in English and Spanish required.
• Motivational Interviewing certification within six months of hire.
• California Driver’s License required.

Responsibilities

• Manage a diverse caseload of adults, youth, and families in the Enhanced Care Management program.
• Screen and assess members for mental health, substance use, and social needs.
• Develop and monitor individualized care plans using strengths-based approach.
• Identify members needing urgent treatment adjustments for prioritization.
• Complete electronic/case management documentation accurately and timely.
• Meet mental health visit goals as required by contracts.
• Provide referrals and liaison services across agencies for health needs.
• Offer crisis intervention and aftercare support; connect to emergency services.
• Educate members about mental health, substance use, and chronic conditions.
• Collaborate with providers to resolve conflicting perspectives and schedules.
• Coordinate warm hand-offs to connect patients with the care team.
• Represent the program and department professionally in all interactions.

Skills

Fluency in English & Spanish

Excellent writing

Care coordination

Behavioral health integration

Education

High school diploma or GED

Motivational Interviewing certification within 6 months

California Driver’s License

Job description

Job DetailsJob Location: 7 Directions 2950 Oakland - Oakland, CA 94601Position Type: Full TimeEducation Level: High SchoolSalary Range: $28.13 - $33.17 HourlyTravel Percentage: Up to 25%Job Shift: DayJob Category: Health CarePOSITION: Care Coordinator I, Integration – Enhanced Care Management DEPARTMENT: Behavioral Health REPORTS TO: Care Coordinator IV, Integration LOCATION: Native American Health Center, Inc. 2950 International Blvd., Oakland, CA 94601 WORK HOURS: Full Time, 40 hours per week, 100% FTE STATUS: Non-Exempt, Union

POSITION SUMMARY

The Care Coordinator functions as a member of an integrated system of care team who will work with providers across NAHC and other systems of care to provide NAHC clients with access to an integrated, holistic system of care. The Care Coordinator will provide care coordination, case management, member navigation, system navigation (internal and external), peer advocacy, health education, mapping individual, family and community supports and assets, panel management support, home visits (when appropriate), and warm handoff services. The Care Coordinator may work with other mental health providers when such treatment is indicated. The Care Coordinator may assist with writing reports when appropriate. The Native American Health Center is an accredited institution and adheres to the standards of excellence set forth by the Accreditation Association of Ambulatory Health Care (AAAHC) and the Commission of Dental Accreditation (CODA).

DUTIES AND RESPONSIBILITIES

• 1. Manage a diverse caseload of adults, youth, and families that meet criteria for the Enhanced Care Management program set by the state with a shared understanding of the respective roles and responsibilities of team members to ensure that collaboration is efficient.
• 2. Screen and assess members for common mental health, substance abuse, and social resource needs.
• 3. Develop, implement, and monitor individual plans of care using a culturally sensitive and strengths-based approach, to assist members and families to cope and/or restore social, emotional, financial and environmental factors that affect and/or are affected by illness.
• 4. Identifies members not improving on health/wellness goals and/or with urgent healthcare needs to assist with prioritization for treatment adjustment or case review with the treatment team.
• 5. Accurately and expediently complete electronic and case management systems documentation and other data collection components related to mental health services.
• 6. Meet mental health visit goals as required for various contracts.
• 7. Provide early intervention, direct services, referrals, and liaison services between agencies as needed to support members with medical, behavioral health, and social services needs to promote overall health.
• 8. Provide individual, group, and family crisis intervention and aftercare/discharge support. Link to emergency services as needed, as well as ongoing case management, which may include interacting with police, psychiatric services, hospitals, and other community agencies and staff.
• 9. Provide member education about common mental health, substance abuse disorders and chronic health conditions and available treatment options.
• 10. Work collaboratively to resolve differing perspectives, priorities and schedules among providers.
• 11. Connect healthcare consumers and family members to other members of the healthcare team through face-to-face encounters known as “warm hand-offs.”
• 12. Represent the program, department and agency in a positive and professional manner at all times.
• 13. Provide appointment reminders to members and facilitate access to services.
• 14. Member Care: Demonstrate understanding and apply working knowledge of safety policies and ensuring safe member practices.
• 15. Employee Safety: Safely performs all duties; follow required protective protocols to ensure personal safety as well the safety of others.
• 16. Must maintain compliance with ergonomic safety standards; be mindful of posture and regularly practice ergonomic stretches.
• 17. HIPAA: Keep all protected health information (PHI) confidential and abide by HIPAA policies for the release and disclosure of any PHI. Will report unauthorized use of disclosure of PHI immediately, to supervisor or HIPAA security officer.
• 18. Work well under pressure, meet multiple and often competing deadlines.
• 19. At all times demonstrate cooperative behavior with supervisors, subordinates, colleagues, clients and the community.
• 20. Other duties as assigned by Supervisor.

QUALIFICATIONS

MINIMUM QUALIFICATIONS

• 1. High school diploma or GED equivalency.
• 2. At least one year experience providing care coordination services, counseling, or case management services.
• 3. Fluency in both English and Spanish.
• 4. Obtain certificate in Motivational Interviewing within the first six months of hire.
• 5. A valid California Driver’s License.
• 6. Excellent writing and facilitation skills.
• 7. Demonstrate understanding of the principles of behavioral and primary health care integration.
• 8. Knowledge of the Bay Area Native American community with a commitment to serving Native Americans and other vulnerable member populations including LGBTQ2S populations.
• 9. Must be able to provide TB and Physical clearance prior to start date.
• 10. Able to furnish Vaccination history prior to start date dependent on role.
• 11. BLS/CPR certification must be obtained prior to start date and kept current at all times.
• 12. If in recovery, 3 or more years of sobriety.
• 13. Knowledge of funding, community resources/services and clinical standards is required.
• 14. Experience working with vulnerable, underserved, homeless and transient populations.
• 15. Must meet standards of character under PL 101-630, section 408, Character Investigation, subsection (a) and PL 101-647, section 231, Requirement for Background Check, subsection (c), and agree that employer can contact the last two employers, the sex abuse detective division of local law enforcement and Child Protective Services of the last two counties in which the person has lived or worked to inquire as to the suitability of the person to work with children.

PREFERRED QUALIFICATIONS

• 16. Current knowledge of Federal/State regulations relative to social work; or willingness to learn about Federal/State regulations relative to social work.
• 17. Cultural knowledge related to Indigenous populations of the SF Bay Area.
• 18. Working knowledge of differential diagnosis of common mental health and/or substance use disorders, when appropriate.
• 19. Working knowledge of evidence-based psychosocial treatments for common mental health disorders, when appropriate.
• 20. Experience working with members who have co-occurring mental health, substance abuse, and physical health problems.

BENEFITS

Benefits: Native American Health Center (NAHC) considers our employees to be our most valuable resource and offers an excellent benefit package: competitive salaries, personal time off (PTO) or sick/vacation leave program, and an employer contribution 403(b) retirement plan to full-time regular status employees. We also provide medical, vision, dental, flexible spending, group term and voluntary life insurance coverage for employees and their dependents—with a percentage of employee contribution for dependent medical premiums. Note to Applicants: Please be advised a post job offer, pre-employment Physical and TB test are required as a condition of employment. Additionally, you may be asked to get a Department of Justice Fingerprinting clearance as a contingency for an offer of employment. Criminal clearances are obtained to protect the welfare and safety of clients receiving services at NAHC.

EQUAL OPPORTUNITY EMPLOYER

EQUAL OPPORTUNITY EMPLOYER: Within the scope of Indian Preference, all candidates will receive equal consideration without regard to race, color, gender, religion, national origin or other non-merit factors. Age Discrimination in Employment Act (ADEA): Native American Health Center abides by the mandates of the ADEA (protecting individuals 40 years and older) and considers age a non-merit factor in all employment decisions and considerations. Americans with Disabilities Act (ADA): Native American Health Center abides by the mandates of the ADA and considers disability a non-merit factor in all employment decisions and considerations. Furthermore, NAHC will make any practical, feasible, and reasonable arrangements to accommodate qualified applicants and employees with disabilities