Care Coordinator

Mount Sinai Health Partners (MSHP) is the management services organization developed to enhance the Health System’s implementation of population health initiatives, that is, programs of care that enhance the patient experience and health status, improve the health of patient populations and reduce utilization and healthcare costs. Population health initiatives particularly focus on preventive care. MSHP provides the infrastructure to support population health initiatives and includes services such as care coordination, information technology, workflow optimization, physician engagement and quality reporting. The Department of Social Work Services takes a leadership role in MSHP Care Management, which is providing essential short-term and long-term care management services for a large diverse group of individuals who have a variety of insurances that are part of value based contracts. The goal of MSHP Care Management is to provide standardized care management services to meet patients’ medical and psychosocial needs, increase quality and reduce unnecessary health care costs.

The Care Coordinator is an integral member of Mount Sinai Health Partners Care Management and is responsible for coordinating care and providing guidance, support and education to patients. The Care Coordinator closely collaborates with the patient’s care team to develop and implement a comprehensive care plan and associated interventions. They interact with patients and family caregivers, as appropriate, to ensure continuity of care, and identification and removal of barriers preventing adherence to care plans. They utilize a variety of  behavioral change modalities while coaching patients and family caregivers on how to make lifestyle behavior changes that can positively impact a patient’s health. In consultation with the patient’s care team, the Care Coordinator provides health education related to symptom management and preventive care and advocates to ensure that patients receive necessary care and services.  

Location This position will include a hybrid of on-site work, community-based home visits and accompaniments and remote work. Location for on-site work is to be determined. The position also requires participation in regular individual and group supervisory meetings (both in-person and remote).

• Bachelor’s degree.
• Commitment and passion to meeting patients where they are at and engaging in community-based care service models. 
• Healthcare and/or community-based experience working with diverse populations with complex chronic illness and/or behavioral health population preferred.
• Proficiency in MS Office. Ability to learn hospital documentation and scheduling systems and care coordination applications.
• Excellent oral and written communication skills, organizational skills, and comfort with advocacy, 
• Ability to foster a supportive environment for patients and work collaboratively as of a team.
• Bilingual (English/Spanish) preferred. 
• Minimum of one year in current position.