Care Coordinator Job St Johns Well Child Angeles
St. Johns Well Child Recruitment 2020Description :
Provide coordination of care for patients with multiple chronic medical and mental health conditions as well as substance use disorders. Promote & enroll patients into SJWCFC Health Homes Program (HHP). Provide administrative support to Health Homes Director at various clinic sites.
Determine needs of high acuity, vulnerable patients and provide basic housing assistance, patient tailored intensive case-management, developing a care/service plan; provide linkages to medical, psychiatric, social, educational and other services as needed. Work with the Homeless Services program staff to provide team-based, patient-centered care management for homeless and at-risk of homelessness patients.. Ability to literally meet the patient where they are to conduct the needed case-management services. Work with medical providers and patients to implement and perpetuate treatment and chronic disease self-management for patients enrolled in HHP within as well as outside of the clinic. Develop and maintain wellness plans. Assist with crises and coordinates support services and reviews progress toward goals. Completes scales and assessments as appropriate. The successful candidate will work primarily with high acuity vulnerable individuals as well as homeless patients, families and those at risk of homelessness.
REQUIRED SKILLS AND QUALIFICATIONS
- Bachelor's Degree
- Oversee provision of HHP services and implementation of HAP
- Offer services where the HHP member lives, seeks care, or finds most easily accessible and within MCP guidelines
- Connect HHP member to other social services and supports he/she/they may need
- Advocate on behalf of members with health care professionals
- Use motivational interviewing and trauma‐ informed care practices
- Work with hospital staff on discharge plan
- Engage eligible HHP members
- Accompany HHP member to office visits, as
- Monitor treatment adherence (including medication)
- Provide health promotion and self‐management training
- Arrange transportation
- Call HHP member to facilitate HHP member visit with the HHP care coordinator
- Report HHP patient progress, concerns and needs to multi-disciplinary team to improve patient care
- Attend & participate in all multi-disciplinary team meetings and work collaboratively with all HHP team & clinic staff
- Three years experience in social/medical services setting providing targeted care management to multi-ethnic communities with knowledge of and experience working with men, women, children and families and chronic disease management.
- Support the integration of programs into medical care
- Experience working with chronically homeless patients with HIV, HCV, and/or substance abuse and patients whom are in immediate-risk of homelessness.
- Experience with and knowledge of homeless individuals and families.
- Experience with Housing First and Harm-Reduction strategies, and Motivational Interviewing.
- Experience with Patient Centered and Trauma Informed Care.
- Experience with Crisis Intervention & Prevention strategies.
- Experience engaging and assisting individuals/families with acute mental illness & substance use to access/navigate health care as well as other needed services.
- Experience working with the HMIS and Coordinated Entry System.
- Bilingual (Required).
- Other duties may be assigned or may be modified as business needs dictate.
Employees are responsible for maintaining individual certifications as required by job function or by law and provide verification and recertification when requested by management.
PRINCIPLE ACCOUNTABILITIES. We acknowledge that all employees should have goals and objectives that support the Mission of St. John’s and that each should be accountable for personal, team and organizational goals.
Duties and Responsibilities include the following but also include duties as assigned within the BH scope of work:
- Conducts intakes and assessments to establish individual patient needs and goals.
- Coordinate all aspects of care; transportation, referral and scheduling.
- Assess Self-management skills of individual patients; Promote and aid patient in establishing self-management skills.
- Link patients to resources in the community, including public benefits and social services.
- Care plan development for patients including goals, objectives and actions to resolve barriers and access to services.
- Maintain client/patient file/record of; appointments, services, follow-ups and assessments (based on DMH/DHSP/other funders).
- Maintain regular contact with patients and document as needed; phone calls, conferences.
- Maintains accurate record keeping, client tracking, data collection and monthly reports.
- Chart case management notes in electronic health records and create alerts for providers, as needed.
- Continued education/training to provide up to date best practice models and policies of working with individuals/families experiencing homelessness, mental illness and/or substance use in order to provide patient centered/trauma informed care services.
- Administers and interprets all screening tools.
- Coordinates care, provides follow-up and monitors schedules and procedures with patients.
- Work with medical providers to determine health priorities and develop appropriate care management plans
- Maintains contact with patients, staff, and funders as needed to help reach individual patient wellness goal(s).
- Attend staff meetings, case conferences, team meetings and trainings as needed
- Fosters team environment in advocate role with staff, interns, and providers.
- Crisis management and patient advocacy
- Coordinates services
- Advocates for patients and agency to community resources.
- Liaison between individual/family and community resources.
- Strengthens the individual/family’s ability to access and meet education, health and social/behavioral service needs.
- Assist individuals and families in building the skills and capacity needed to successfully navigate healthcare and social service systems.
The mission of St. John’s Well Child and Family Center is to improve and maintain the health of children and their families regardless of their ability to pay, and enhance the community’s access to health care, by providing a medical home offering preventive and primary medical, dental and mental health treatment for underserved, uninsured and economically disadvantaged persons. The Center also serves a critical function in early identification and referral for serious medical conditions requiring more advanced medical treatment. Our Clinics serves chronically underserved, uninsured and economically disadvantaged families. St. John’s Well Child and Family Center has been involved in increasing the availability and access to health care for the
medically indigent since 1963.
The vision of St. John's is to deliver high-quality primary and preventive medical, dental, and mental health services that go beyond the borders of tradition to uninsured, underserved, and economically - disadvantaged persons in Los Angeles. We are devoted to instilling the value of well-being to our communities, resulting in self-advocacy, self-esteem, and self-sustenance through innovative and developmental programs and collaborative endeavors.
We honor and respect every person we encounter as a valued member of the human family whose gifts and rights are to be protected.
We support and champion individual and organizational growth, accountability, creativity, teamwork, and commitment to quality, and the best standard of care.
We promote and advocate for the full integration of our patient’s physical and mental health with their needs as an active member of a vibrant and just community.
We collaborate with others to develop systems, organizations, and programs that address the needs of and empower all members of our community with a preference for the most vulnerable and disadvantaged.
Commitment to Process Improvement
Employees will make a commitment to the change process and embrace new systems and technology designed to enhance employee skills and improve patient care.
Employees will actively engage in designing, implementing and optimizing new systems for efficient operating.
Employees will be dedicated to a patient-centered medical home model fostering excellence in customer service and patient care.
Employees will provide cross functional support to other employees which means you will be responsible for “other duties as assigned” to pick up the workload and rebalance the workload for continued efficiency in patient care.
Essential Job Functions include the following:
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job and include the ability to type and operate a personal computer with various software programs, effectively operate standard office equipment, bend, stoop, crouch, kneel, twist, balance, and work at a desk, lift and carry up to 25 pounds, and communicate (written and oral) in a clear and professional manner.
Mental/Cognitive Demands: Establish and maintain effective work relationships with co-workers and customers, maintain regular attendance, understand and carry out a variety of oral and written instructions, have knowledge of proper English usage, grammar, punctuation, spelling, and vocabulary, have the ability to learn office principles, practices, and methods, understand filing systems, including numerical, alphabetical, and chronological, learn a variety of procedures, policies, and services of the assigned work unit or program, perform assigned duties with efficiency and accuracy and maintain confidentiality.
Competencies are metrics used to measure how well you perform your duties and responsibilities on the job. For example, one employee may handle X numbers of patients per day but when surveyed, the way the patient was handled or mishandled speaks to competence. Competence is measured on a scale of 1 (low) to 5 (high).
1 Results Orientation
- Employee takes initiative and sets high goals and consistently achieves goals as assigned.
- Quality of work is accurate and has consistent neatness and detail.
- Quantity of work meets goals and deadlines. Maintains a steady pace under pressure.
2 Decision Making and Problem Solving
- Weighs all facts before making a decision and willing to take action within limits.
- Consults with superiors before taking action. Digests relevant information.
- Anticipates and prevents problems before they get out of hand.
- Uses sound logic and factual information to analyze situations.
- Knows how to find information relevant to circumstances.
- Can withhold personal feelings and politics when making decisions.
4 Oral and Written Communication
- Is effective in one-on-one and group situations.
- Can listen and respond appropriately discussing matters.
- Provides professional responses to internal patients and external vendors.
5 Flexibility and Dependability
- Performs effectively when faced with varying operating conditions.
- Punctual, attentive and accepts responsibility for all duties assigned.
- Can adjust quickly to changing environments and demanding situations.
6 Job knowledge and Technical Skills
- Proficient in job knowledge and technical skills required for the position.
- Shows understanding and demonstrates skills as needed.
- Learns new skills and terminology as appropriate in a changing environment.
7 Planning and Organizing
- Schedules time effectively, meets deadlines, to achieve all goals and objectives.
- Plans each day with priorities and accomplishes daily, weekly and monthly goals.
- Demonstrates good time management and strong administrative skills.
- Accepts corporate mission and objectives and is aligned properly to outcomes.
- Keeps supervisor informed with updates, reports, and changes.
- Supervises with integrity and demonstrates leadership when assigned employees.
9 Teamwork and Developing Others
- Builds teamwork and team spirit among all employees.
- Maintains solid working relationships that support and encourage one another.
- Enforces team concepts over personal bias and individual opinions.
- Maintains composure and objectivity when under pressure.
- Embraces change and new challenges with enthusiasm and energy.
- Handles themselves in a mature and professional manner.
11 Building Relationships
- Maintains rapport with employees, patients and stakeholders.
- Manages conflict constructively to achieve mutually beneficial outcomes.
- Builds consensus and overcomes.
- Employee is a positive role model and demonstrates integrity on the job.
- Develops others to maximum capacity for growth and incremental improvement.
- Manages others to win loyalty and commitment.
13 Awareness: Internal and External
- Understands internal corporate culture and can maneuver as required.
- Keeps abreast of new services and changes that affect the business.
- Keeps informed on community, political and legal matters pertaining to St. John’s.
14 Quality Control: Improvement of Patient Care and Profitability
- Exceeds patient expectations in providing services to our community.
- Properly matches patient needs to appropriate referral service(s).
- Supports St. John’s Mission with enthusiasm and in a caring manner.
For further information, please refer official source from St. Johns Well Child on following link below. To find out where you fit in, please visit :
- All application will kept strictly confidential.
- Only qualified, short-listed applicants will be invited for furthers process.
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