HEALTH HOME CARE COORDINATOR - Must be bilingual-English and Cambodian

The Korean Women's Association (KWA) is an equal opportunity employer. It considers all applicants without regard to race, color, national origin, religion, gender, marital or military status, age, sexual orientation gender identity, the presence of any sensory, mental, or physical disability, genetic information or any other protected characteristic.

1. Purpose of Position

The Health Home Care Coordinator works with clients to develop a health Action Plan (HAP) and participate in health home services by working with clients to coordinate care to ensure that they receive the right care, at the right time, while utilizing the best resources.

Health Home Services supports members with their ongoing chronic conditions and assist them once a month with in-person visits to meet their health goals. Improves coordination and care for medical and other service needs, such as long-term services and supports, mental health services, and dependency services. Health Home Services reduces gaps in service and increase s coordination between all of their providers.

2. Essential Duties and Responsibilities

•Assess care planning and implement and coordinate services
•Provide/arrange for support to clients for effective improved self-management skills, enhanced client- provider communication, and care transitions.
•Facilitate interdisciplinary consultation, collaboration, and care continuity across care settings
•Engage clients in care coordination activities designed to promote improved utilization of health care services
•Create and maintain a patient-centered, goal-oriented Health Action Plan
•Assess activation level of self-care using Patient Activation Measure (PAM)
•Provide evidence-based health assessments and screenings such as BMI, PHQ-9, Katz ADL, GAD-7

•Provide referrals and advocacy for clients and their caregivers to community long term services and supports, which includes family caregiver programs, nutrition programs, in-home care, and case management, etc.
•Develop and maintain complete and concise client files in compliance with policy to appropriately document activities performed for the client and all elements required for specific programs
•Advocate on behalf of client
•Comply with health care regulations and ensure client confidentiality

3. Secondary Duties and Responsibilities

•Arrange for transition support services, generally based on the Coleman model of Care Transition Intervention
•Maintain all required documentation related to services provided conforming to monthly deadlines
•Participate in staff meetings, public education, and provider training sessions, as appropriate
•Collaborate on any necessary interventions
•Participate in continuing education and training programs

4. Position Requirements, Competencies and Qualifications

•Must speak Cambodian in order to communicate with clients who are only proficient in that language.
•Valid/current WA State Driver's License with current automobile insurance
•Ability to Successfully pass a background check according to DSHS/ALTSA and agency policies
•Ability to acquire proficiency in respective client documentation platforms
•Well-developed human relations skills and ability to work in a team-based environment
•Excellent communication skills, oral and written
•Skill in interviewing clients in person, on the phone, and others involved as relevant, to elicit information and impact client situation
•Knowledge of Microsoft Office Suite Word, Excel, Outlook email programs and database applications
•Ability to utilize other computer programs and systems that may be specific to positions or duties

4.1 Education and Experience:

•Associate Applied Science Degree
•1 year minimum as a Behavioral Health Care Coordinator, Case management or/and Social Service experience.
•One year of experience in In Home Care administration and Human Resources preferred; education may be substituted for experience
•Experience meeting and work