Care Coordinator (Queens)

New Horizon Counseling Center is seeking a Health Home Care Manager to join our team and help individuals with complex medical, behavioral health, and social needs successfully live in the community.

This is a hands-on, community-based position for someone who enjoys building relationships, advocating for clients, coordinating services, and helping people overcome barriers to care.

As a Health Home Care Manager, you will work directly with clients to assess their needs, develop individualized care plans, coordinate services, and connect them with resources that support their health and stability.

Your responsibilities will include:

• →Engage clients in the community through face-to-face outreach and regular contact.
• →Complete initial and ongoing assessments to identify client strengths, needs, goals, and barriers.
• →Develop and implement individualized care plans with clients and their providers.
• →Coordinate appointments and follow-up care with primary care, behavioral health, hospitals, rehabilitation facilities, and other providers.
• →Assist clients transitioning from hospitals, emergency departments, or rehabilitation programs back into the community.
• →Identify and address gaps in care, including missed appointments, medication concerns, and unmet healthcare needs.
• →Connect clients to resources addressing housing, food insecurity, transportation, benefits, employment, and other social determinants of health.
• →Assist clients with accessing benefits and community resources such as SSI/SSD, SNAP, HEAP, Medicaid, housing programs, and other supportive services.
• →Advocate for clients and help them navigate complicated healthcare and social service systems.
• →Collaborate with providers, family members, community agencies, and other members of the client's care team.
• →Maintain accurate and timely documentation, care plans, assessments, and required reports.
• →Travel regularly throughout the community to meet with clients and providers

• Bachelor's degree in Social Work, Human Services, Psychology, Public Health, or a related field.
• At least one year of direct human services experience working with individuals with serious mental illness, HIV/AIDS, disabilities, or other complex needs preferred.
• Strong communication, organization, documentation, and advocacy skills.
• Ability to build trusting relationships with individuals from diverse backgrounds.
• Ability to work independently while also collaborating effectively with a team.
• Reliable transportation and the ability to travel regularly throughout the community.

• Experience in Health Home, care management, behavioral health, case management, social services, housing, hospital discharge planning, or community-based services.
• Bilingual/multilingual skills.
• Experience working with Medicaid, SSI/SSD, SNAP, housing, or other public benefits.

You may be a great fit for this position if you are someone who:

❤️ Enjoys helping people solve problems and navigate systems
🤝 Builds relationships easily and treats clients with dignity and respect
📋 Is organized and able to manage multiple clients and deadlines
🚗 Is comfortable working in the community and meeting clients where they are
🗣️ Is a strong communicator and advocate
💡 Can think creatively when helping clients overcome barriers

🌱 Wants meaningful work where you can see the impact you're making

If you're looking for a career where you can connect people to care, advocate for vulnerable individuals, and help clients achieve greater stability and independence, we'd love to hear from you.