Health Home Integration Specialist – Care Coordination

Sea Mar Community Health Centers; Lacey (WA); Hybrid; USD 31,000 - 44,000; Full time

Benefits offered by this job

Health benefits package

Paid time off + holidays

401(k) retirement options

Dental insurance

Vision insurance

Life Insurance

Long Term Disability

Employee Assistance Program (EAP)

Job summary

Sea Mar Community Health Centers is seeking an Integration Specialist to provide Health Home services and care coordination for patients with complex medical and behavioral health needs. You will meet clients in homes, communities, clinics, or other settings to create a Health Action Plan and coordinate referrals to internal and community resources.

You will work within a multidisciplinary Care Management team, leveraging motivational interviewing to support long-term health goals, monitor

Qualifications

• Bachelor-level degree in social services or health-related field is required.
• Ability to work with diverse populations and maintain professional boundaries.
• Excellent organizational and communication skills; CPR/BLS may be required.

Responsibilities

• Reviews screenings and coordinates with care providers to support patient goals.
• Develops Health Action Plans with patients including long- and short-term goals.
• Provides six core Health Home services: health promotion, care coordination, and referrals.
• Maintains documentation of calls, visits, and outcomes; follows up regularly.

Skills

Bilingual English/Spanish preferred

Interdisciplinary teamwork

Education

BSW or BA/BS in Human Services, Health Sciences or related field

Tools

Microsoft Office

EHR systems

Job description

Sea Mar Community Health Centers is seeking an Integration Specialist to provide Health Home services and care coordination for patients with complex medical and behavioral health needs. You will meet clients in homes, communities, clinics, or other settings to create a Health Action Plan and coordinate referrals to internal and community resources.

You will work within a multidisciplinary Care Management team, leveraging motivational interviewing to support long-term health goals, monitor