Integration Specialist; BA

Sea Mar Community Health Centers, a Federally Qualified Health Center (FQHC) founded in 1978, is a community-based organization committed to providing quality, comprehensive health, human, housing, educational and cultural services to diverse communities, specializing in service to Latinos in Washington State. Sea Mar proudly serves all persons without regard to race, ethnicity, immigration status, gender, or sexual orientation, and regardless of ability to pay for services.

Sea Mar's network of services includes more than 90 medical, dental, and behavioral health clinics and a wide variety of nutritional, social, and educational services. We are recruiting for the following position:

Sea Mar is a mandatory COVID-19 and flu vaccine organization

Integration Specialist (BA) - Posting #27369

Hourly Rate: $26.52

Position Summary:

Full-time Integration Specialist position available for the Care Management department in Anacortes, WA.The Integration Specialist provides Health Home services and similar support for patients whose complex medical, behavioral health and social concerns impede their ability for self-care. Must have knowledge of Community Outreach or Case Management. Knowledge of Community Resources preferred. Willingness to commute to meet with clients at various settings including clients home, clinic and/or hospital.

The Integration Specialist is a member of the patient-centered inter-disciplinary Care Management team, and has a strong understanding of chronic conditions and how each condition can compound another, leading to poor health outcomes.

The Integration Specialist meets with patients in the location of their choice; their homes, in the community, at in-patient settings or in clinics. This individual’s work will include timely and effective screenings and appropriate referrals to internal Sea Mar service providers, community-based resources, and emergency services when indicated.

Screenings may pertain to functional abilities, daily medical self-management skills, fall risk, depression, anxiety, drug and alcohol use, and other screenings when indicated. Through the use of motivational interviewing and other techniques, the Integration Specialist will work with the patient to create a Health Action Plan which includes long and short term goals with actionable steps that will help the client self-manage their chronic health conditions.

As part of ongoing services, the Integration Specialist will follow up with the patient regularly to evaluate progress made towards completing their Health Action Plan goals. As part of the Care Management/ Health Home six core services, the Integration Specialist provides care transition assistance from in-patient settings, follow-up in the home, as well as community based care coordination, health promotion, patient and family support, referral to community and social support services, and comprehensive care management.

As part of the clients’ interdisciplinary team, the Integration Specialist will provide information and recommendations regarding the client’s care. Must have experience working in the community with underserved populations required.

Requirements and/or Responsibilities:

• Must be able to complete job responsibilities in various locations; client’s home setting, community setting, or clinic.
• Ability to understand medical terminology pertaining to chronic conditions.
• Ability to work with an interdisciplinary care team including medical providers, nursing staff, care coordinators, behavioral health and support staff.
• Must be able to perform independently and at the same time perform effectively and professionally as an interdisciplinary team member.
• Must be able/willing to work with translators if not bilingual.
• May carry a caseload of 60 patients as assigned by Care Manager.
• Provides up to two contacts per month for high-intensity patients (one face-to-face contact and one telephone contact with patient, providers, or caregivers) with a step down to telephone contact when the patient has demonstrated stability.
• Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
• Ability to…