Care Specialist; 4601-207 - Queens, United States - Catholic Charities Brooklyn and Queens

Catholic Charities Brooklyn and Queens

Verified Company

Queens, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

For over 125 years, Catholic Charities Brooklyn and Queens has been providing quality social services to the neighborhoods of Brooklyn and Queens, and currently offers 160-plus programs and services for children, youth, adults, seniors, and those struggling with mental illness.

Children's Care Coordination provides services to children ages 5 to 18 enrolled in the various Health Homes Program.

The primary goal and service philosophy of the program is to provide recovery-oriented care coordination which is widely available, accessible, flexible, personally tailored and responsive to the individual child and family needs.

The goal is to connect clients and families to various community resources identified as beneficial to the clients' overall holistic well-being in order to reduce emergency room visits, inpatient stays and incarcerations.

STATEMENT OF THE JOB:

Under the direct supervision of the HH Team Supervisor, the Care Specialist has overall day-to-day responsibility and accountability for coordinating all aspects of care for assigned health home serving children members with complex medical and/or psychiatric co-morbid conditions and for facilitating their access to the full range of medical, behavioral health, substance use, social and psychosocial services in the community, in an efficient and effective manner.

Accountable for engaging and retaining Queens health home members in care, coordinating and arranging for the continuous provision of services, supporting adherence to treatment recommendations, monitoring and evaluating their needs, including prevention, wellness, medical, specialist and behavioral health treatment, care transitions, and social and community services where appropriate through the creation of an individual plan of care.
In collaboration with the health home members, their family and/or caregivers, and other service providers develops, manages and coordinates a comprehensive individualized personcentered care plan that coordinates and integrates the continuum of medical, behavioral health services, rehabilitative, long term care and social service needs and clearly identifies the primary care physician/nurse practitioner, specialists, behavioral health care providers, care manager and other providers directly involved in the individual's care.
Ensures the availability of priority appointments for health home members to care services including physical, psychiatric, and substance abuse within their health home provider network to avoid unnecessary, inappropriate utilization of emergency room and inpatient hospital services.
Promotes evidencebased wellness and prevention by linking health home members with resources for smoking cessation, diabetes, asthma, hypertension, selfhelp recovery resources, and other medical services based on individual physical needs and preferences.
Tracks and shares health home members' information and care needs across providers by utilizing electronic databases and monitors outcomes and initiate changes in care, as necessary, to address health home members' needs.
Reassesses needs for Health Home services and reviews health home members' historical or targeted clinical measurements (i.e. number of ER visits and inpatient psychiatric admissions).
Completes contact notes, incident reports, and other required documentation and maintains accurate recordings in electronic case files in a requested timely fashion.
Completes CANS-NY training and examination to properly assess clients being served
Checks that health home members receive test results and tracks that patients follow up with medical directions. Prepares and followsup on a list of health home members who need preventive or metabolic screening, appointment reminders.
Outreach via phone to health home members between visits (check on selfcare, medication fills, treatment plan, schedules visits, tests/followup) Monitors that the health home member completes postvisit followup (fill prescriptions, make appointments).
Monthly Face to face visit with client/child as well as monthly follow up (telephonic or face to face) with various providers/collaterals (i.e. guidance counselors, parents/guardians, therapists, ACS etc.)
Aids the health home members in identifying the primary care physician and multidisciplinary teams of medical, mental health, chemical dependency treatment providers, social workers, nurse's nutritionists/dieticians, pharmacists, outreach workers including peer specialists and other care providers to assure that enrollees receive needed medical, behavioral, and social services in accordance with a plan of care.
Responsible for maintaining the security of all data files and employ approved methods of data encryption to prevent theft of personally identifiable information.
Refer Queens health home members to peer supports and coordinate peer supports, support groups, and selfcare programs to increase client's and caregivers know