Care Coordinator, Population Health Services

Essential Functions

• Assessment and Planning: Conducting thorough assessments of patients' social and emotional needs, including bio-psychosocial factors, social history, and potential barriers to care.
• Resource Connection: Identifying and connecting patients with appropriate community resources, such as support groups, financial assistance programs, and other relevant services.
• Treatment Planning: Developing and implementing individualized treatment plans in collaboration with patients and other healthcare team members.
• Advocacy: Advocating for patients' needs and ensuring they receive the necessary support and services.
• Crisis Intervention: Providing crisis intervention and support to patients experiencing emotional distress or facing urgent situations.
• Documentation: Maintaining accurate and timely documentation of patient interactions, assessments, and interventions.
• Collaboration: Working closely with other healthcare professionals, such as physicians, nurses, and other social workers, to ensure a coordinated and comprehensive approach to patient care.
• Education: Educating patients and their families about relevant resources, treatment options, and coping strategies.

Requirements

• Master’s degree in Social Work (MSW) is required
• State licensure as a Licensed Clinical Social Worker (LCSW) or similar is preferred
• Experience in healthcare settings, particularly in ambulatory or outpatient care, is preferred
• Strong assessment, counseling, and crisis intervention skills are essential
• Excellent communication, interpersonal, and organizational skills are crucial
• Familiarity with electronic health records (EHR) and case management software is preferred