Care Coordinator (Integrated Health)

IHH Care Coordinator

The Integrated Health Home Care Coordinator’s primary responsibility is to respond to the needs of adults with a Serious Mental Illness (SMI) using a patient-centered approach which removes silos of care and supports an integrated system. This position will provide whole-person care coordination across medical, behavioral, and social service community systems.

Essential Duties and Responsibilities:

• Establish and maintain routine collaborative meetings with system partners to achieve benchmark standards and improve patient care.
• Participate in Quality Improvement activities, including data collection, tracking, and analysis.
• Conduct in-depth interviews/assessments and use specialized knowledge to gather complicated information from patients to be enrolled in the IHH.
• Demonstrate excellent customer service and collaborate with physicians, consumers, members, visitors, staff, and the health care community.
• Collaborate with Health Home Team and treating providers in developing and implementing care coordination plan to address treatment barriers for each low to moderate risk patient.

• Demonstrate flexibility in job duties and schedule in order to aid in better serving the organization, the consumers, and to assist reaching benchmark standards. Allow for flexibility in scheduling to accommodate crisis situations for patients.

• Uses available data, such as exams/assessments scores, participant evaluations, and service observations to identify health and wellness needs to develop care coordination plans.