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About the Role

Care Coordination is a service model where all of an individual's caregivers communicate and interface to ensure the patient's needs are addressed comprehensively. A Care Coordinator oversees and provides access to all necessary services to maintain health and prevent hospitalizations.

Responsibilities

• Obtain required enrollment consents from the individual or legal guardian.
• Complete initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the most appropriate level of care coordination.
• Manage the patient’s Individualized Plan of Care, coordinating services, supporting adherence to treatment, and monitoring patient needs.
• Meet documentation requirements accurately and timely using the Care Coordinator Portal (Medicaid Analytics Performance Portal; MAPP) and Electronic Health Records (EHRs).
• Maintain required contact with participants and their families, conducting face-to-face support team and/or family meetings.
• Act as an advocate for clients within the agency and with external service providers.
• Promote wellness and prevention by linking enrollees with resources and services based on their needs and preferences.
• Communicate and share information effectively with the individual, families, and other caregivers, considering language, literacy, and cultural preferences.
• Participate in care planning meetings/conferences as an interdisciplinary team member.
• Identify available community-based resources and manage referrals, access, engagement, follow-up, and coordination of services.
• Engage in the discharge planning process for hospitalized patients, ensuring post-discharge services are in place.
• Arrange appointments, transportation, and interpreter services when needed.
• Accompany the child to appointments as needed.
• Conduct follow-up activities to ensure appointments are kept.
• Participate in ongoing staff development trainings to enhance skills.
• Perform other duties as assigned.

Requirements

• Bachelors of Arts or Science with two years of relevant experience.
• Master’s Degree with one year of relevant experience (preferred).
• Registered Nurse with two years of relevant experience (preferred).
• Working knowledge of healthcare provision in various settings.
• Ability to work directly with diverse populations including Severely Emotionally Disturbed (SED), Medically Fragile (Med F), Developmentally Disabled (DD), and Division of Juvenile Justice.
• Computer Literacy (Microsoft Word, Excel).
• Excellent telephone and interpersonal skills.
• Ability to work directly with a diverse multidisciplinary team.
• Willingness and ability to travel to assigned operational areas/facilities.
• Ability to be flexible with programmatic needs and changes.
• Capable of effective clear direct communication with others (oral and written).
• Proven time management abilities, including meeting deadlines, ensuring compliance with agency policy and procedures, and overseeing complete and timely maintenance of agency records.
• Valid NYS Driver’s License if using personal or agency vehicle for business.

Skills

• Care Coordination
• Needs Assessment
• Individualized Plan of Care Management
• Medicaid Analytics Performance Portal (MAPP)
• Electronic Health Records (EHRs)
• Client Advocacy
• Community Resource Management
• Discharge Planning
• Appointment Scheduling
• Transportation Arrangement
• Interpreter Services Arrangement
• Microsoft Word
• Microsoft Excel
• Telephone Skills
• Interpersonal Skills
• Multidisciplinary Team Collaboration
• Flexibility
• Oral Communication
• Written Communication
• Time Management
• Meeting Deadlines
• Compliance Management
• Record Maintenance

Location

• Wading River
• Long Island

Work Type

• Full-time

Experience Level

• Two years of relevant experience (minimum)
• One year of relevant experience (preferred with Master's)

Education Level

• Bachelors of Arts or Science
• Master’s Degree (preferred)
• Registered Nurse

Salary/Compensations

• Commensurate with experience & skills

About the Company

• Little Flower Children and Family Services of New York is a nonprofit organization that has worked to improve the well-being of children, youth, families, and people with developmental disabilities across New York City and Long Island since 1929.
• Our staff of more than 500 provides prevention services, foster care, residential treatment care, adoption services, medical and mental health services, and programs and services for individuals with developmental disabilities.
• A career with Little Flower can be rewarding in many ways.
• We are looking for conscientious and caring people ready to commit to strengthening families and supporting the well-being of children and adults with developmental disabilities.
• Little Flower Children and Family Services of New York and St. John’s Residence for Boys have a long-standing history of serving children, youth, adults and families of color.
• Our mission, vision and values are grounded in elevating the shared humanity of every staff member, community partner and those with whom we engage.

Equal Opportunity

• We recognize that our DEIB work is continuously evolving as we strive for equity and inclusion for individuals of all races, ethnicities, genders, sexualities, ages, abilities, religions and lived experiences.