Integrated Care Coordinator - South Bend (Regional)

Description

Indiana Health Centers, Inc. (IHC) is a mission-driven organization providing high-quality, affordable healthcare to underserved and uninsured populations since 1977. At IHC, a Federally Qualified Health Center, we specialize in integrated care which means having access to essential services to meet the needs of patients we serve in the community. With ten healthcare centers and eight Women, Infants, and Children nutrition program locations throughout Indiana, we offer primary medical, dental, and behavioral healthcare services to community-based patient populations that are diverse in age, educational background, and income level.

The Integrated Care Coordinator contributes to IHC’s mission and goals of client satisfaction, quality of care, and productivity. The Integrated Care Coordinator works collaboratively with Behavioral Health providers to secure patient access to evidence-based clinical intervention programs within and outside of IHC. They are responsible for tracking treatment outcomes and facilitating treatment plan changes in consultation with the Patient Care Team, when appropriate.

Travel is required with this role. Approximately 60 percent of the time is spent in the community, and 40 percent in the office/clinic. This can vary based on clinic/patient needs as determined by management.

Meet our South Bend Team: https://indianahealthonline.org/locations/south-bend/

Hours of Operation:

Monday - 8:00 AM - 5:00 PM

Tuesday - 8:00 AM - 6:00 PM

Wednesday - 8:00 AM - 6:00 PM

Thursday - 8:00 AM - 6:00 PM

Friday - 8:00 AM - 4:00 PM

Saturday (1st & 3rd) - 8:00 AM - 12:00 PM

Sunday - Closed

IHC's excellent benefits and compensation package includes:

• $2000.00 retention bonus paid after one year
• Day 1 Insurance benefits eligibility: Two (2) Medical plan options (PPO/HSA), Dental, Vision, FSA, HSA
• Employer contribution to Health Savings Account when elected
• 403(b) Retirement Plan matching at one year of employment
• Generous Paid Time Off and Floating Holidays
• Employer-paid Group Life, Short-term disability, and Long-term disability coverages
• Flexible Leave of Absence programs
• Two (2) Employee Assistance Programs with 24/7 access to consultive services
• Annual reimbursement for position-specific Continuing Education

Integrated Care Coordinator Job Summary

• Work with patients at the health center and at the community level to enhance understanding and adherence to their evidence-based intervention programs.
• Identify barriers to accessing appropriate healthcare or other concerns with the patient’s home and community environment.
• Provide direct assistance to patients in gaining access to needed services and assistance programs. Assist patients with completing Medicaid and/or marketplace (if certified) applications.
• Develop individualized plans to meet patient needs. These plans can be linked to PCMH care plans.
• Collaborate with the Patient Care Team to secure needed medical services for clinically indicated services outside of the organization (e.g., social services such as housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).
• Monitor PCMH care plans and reflect this in documentation follow up visits in the EMR system.
• Systematically track treatment response and monitor patients (in person or by telephone) for changes in clinical symptoms and treatment side effects or complications.
• Support psychotropic medication management as prescribed by medical providers, focusing on treatment adherence monitoring, side effects, and effectiveness of treatment.
• Provide brief behavioral interventions using evidence-based techniques such as behavioral activation, problem-solving treatment, motivational interviewing, or other treatments as appropriate.
• Develop supportive relationships with patients, their families, local agencies, and community partners to assist patients in meeting their goals.
• Identify resources available and offered with community partners. Regularly visit community partners to collaborate and develop plans for assisting patients and to ensure resources are up to date.
• Regularly follow up with patients to reassess needs and monitor progress. Facilitate treatment plan changes for patients who are not improving as expected in consultation with the Patient Care Team.
• Conduct home visits to patients and/or families if deem