Care Coordinator - Community Support Programs

Job Description

Job Description

Description :

The Bridge offers supportive housing and behavioral health services to vulnerable New Yorkers facing behavioral health and substance use challenges. We provide individuals with the tools they need to pursue their dreams and live meaningful lives. The Bridge envisions a world where adults experiencing serious mental illness can live and thrive within their communities. As a recognized leader in developing and operating supportive housing and community-based programs, The Bridge has 70 years of experience helping New Yorkers with mental illness, including those affected by homelessness, incarceration, and institutionalization.

Scope of Position : Under the direction of the Clinical Supervisor, the Care Coordinator works closely with members and their network of providers to reduce barriers to care and support the achievement of improved health outcomes. Utilizing interventions such as care coordination, motivational interviewing, and health promotion, the Care Coordinator helps members develop the skills needed to independently manage their health and psychosocial needs. This role offers the opportunity to be part of an outcome-driven, integrated team focused on enhancing the care delivery for individuals living with chronic illness and behavioral health challenges.

Essential Position Functions :

• Collaborate with adults facing serious mental illness, chronic conditions, and substance use disorders within the Health Homes Program.
• Conduct initial and follow-up assessments of members' comprehensive needs, including medical, mental health, substance use, financial, and housing.
• Develop person-centered care plans with input from providers and members, ensuring adherence to Health Home standards.
• Work with medical and behavioral health staff to create and implement care plans for chronic illnesses, following Health Home guidelines.
• Coordinate member services with all providers through regular case conferencing.
• Conduct field visits to provide services in various settings, including shelters, substance abuse programs, and hospitals.
• Document all contacts and maintain records within required time frames.
• Participate in staff meetings, supervision, conferences, and training sessions.
• Adhere to all approved Bridge personnel Health Home policies and procedures.
• Perform additional duties as assigned.

Requirements :

The Bridge Inc. is an Affirmative Action / Equal Opportunity Employer