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About the Role

The Integrated Support Care Manager provides integrated care management services to patients using a harm reduction approach to address psychosocial barriers to care. This role involves coordination of care, psychoeducation, casework counseling, linkage to community supports, referral follow-up, and maintaining communication with patients and care teams. The position requires ongoing training to understand the needs of patients, including HIV, Substance Use, Hepatitis C, mental health, and chronic conditions. Job duties must be performed in compliance with systems and job-specific standards.

Responsibilities

Complete care management intakes and support MAT addiction programs
Develop, implement, and monitor individualized patient care plans
Establish linkages and refer patients to internal and external support services; provide follow-up on referrals
Complete patient Recovery Support Plans and Crisis Plans as appropriate
Communicate and collaborate effectively with patients and interdisciplinary care teams, including providers
Provide Naloxone training to patients and staff
Conduct and/or support HIV testing and ensure linkage to appropriate services and follow-up
Participate in case conferencing with care teams
Maintain accurate, current case records and complete required documentation and reports in a timely manner
Demonstrate knowledge of stages of change, substance use disorders, HIV, HCV, and other co-occurring conditions
Empower, educate, and link patients to HIV, HCV, and STI testing and treatment, PrEP, substance use services, and primary care
Participate in ongoing training to enhance professional skills and patient care
Support quality improvement initiatives and perform other duties as assigned

Requirements

Ability to communicate in English, both orally and in writing
Ability to communicate in Spanish, both orally and in writing, preferred
Experience in health or social services
Knowledge of the geographic community served and available resources
Maintains a customer service level commensurate with the expectations of the Mission Statement
Ability to collaborate with other members of Hudson River HealthCare to maintain high-quality standards and achieve client satisfaction
Possesses the emotional, mental, and physical capability to perform duties and demonstrates a strong commitment to achieving goals
Demonstrates initiative, enthusiasm, creativity, and strong verbal and written communication skills
Ability to organize work effectively, accept and utilize guidance, and work cooperatively
Possesses flexibility, cultural sensitivity, and the ability to maintain confidentiality

Skills

Harm reduction approach
Coordination of care
Psychoeducation
Casework counseling
Linkage to community supports
Referral follow-up
Communication with patients and care teams
Understanding of HIV
Understanding of Substance Use
Understanding of Hepatitis C
Understanding of mental health
Understanding of chronic conditions
Naloxone training
HIV testing
Stages of change
Substance use disorders
HCV
STI testing and treatment
PrEP
Primary care

Location

Poughkeepsie
Amenia
Manchester Road

Work Type

Full-Time

Education Level

High School Diploma or GED
Associate degree
Certified Recovery Peer Advocate (CRPA)

Salary/Compensations

$23.00 - $26.37 per hour

Benefits

Medical, Dental and Vision Insurance
Life and Disability Coverage
Retirement Savings Plan
Commuter and Transit Benefits
Employee Assistance Program (EAP)
Employee Discount Program
Professional Development
Education
Loan Assistance Benefit Programs
Federal and state loan repayment or loan forgiveness programs
Tuition Reimbursement Program

About the Company

Sun River Health has a rich history of providing quality, affordable health care to communities in need.
Founded in the early 1970s by four African American women in Peekskill, New York, the organization was established to address the lack of accessible health services in their community.
With the help of a small federal grant, the first Sun River Health site opened its doors in 1975.
Over the years, Sun River Health has grown into a comprehensive Federally Qualified Health Center (FQHC) system with over 50 locations, serving more than 250,000 patients across the Hudson Valley, New York City and Long Island.
Our exceptional primary care practitioners, specialists and support staff are dedicated to delivering high-quality care to all individuals, regardless of their ability to pay.
In December 2018, Sun River Health expanded its reach by merging with Brightpoint Health, an FQHC network offering integrated medical, behavioral and social support services in New York City.
This merger allowed us to enhance our services and continue our mission under the unified name of Sun River Health.
At Sun River Health, we believe in fostering a culture of wellness, inclusivity and recognition.
Our Workforce Wellness Program promotes staff wellness through ongoing challenges and activities, encouraging participation and rewarding engagement.
We celebrate our staff's dedication and person-centered spirit through the Planetree Recognition Awards, which honor innovation, leadership and community spirit.
We are committed to creating a supportive and collaborative work environment where all team members can thrive.
Our values of respect, integrity and excellence guide our interactions with patients and colleagues alike, ensuring that everyone receives the care and support they deserve.
Sun River Health is committed in fostering continued growth, education, and professional advancement across its organization.
Through a range of development opportunities and loan repayment programs employees are supported at every stage of their careers.
Eligible employees may have the opportunity to participate in federal and state loan repayment or loan forgiveness programs, including those administered by the Health Resources and Services Administration (HRSA) and the National Health Service Corps (NHSC) with support provided throughout the application process.
In addition, Sun River Health offers a Tuition Reimbursement Program for eligible employees that supports job-related coursework completed through accredited institutions, helping employees continue building their skills and advancing their careers.
Mission-Driven Work: Be part of a proud network of care that offers high-quality health and social support services to communities in need.
Professional Growth: We provide opportunities for career advancement and professional development.
Supportive Environment: Our culture promotes wellness, inclusivity, and recognition, ensuring a supportive and collaborative work environment.
Community Impact: Make a difference in the lives of individuals and families by providing quality, affordable health care.
Join us at Sun River Health and be part of an award-winning network of care that has been serving our communities since 1975.
We are always looking for skilled and dedicated professionals to join our team and help us continue our mission of providing quality health care to all.

Equal Opportunity

Sun River Health provides equal employment opportunities to all qualified individuals without regard to race, creed, color, religion, national origin, age, sex, marital status, sexual preference, or non-disqualifying physical or mental handicap or disability in each aspect of the human resources function.