Integrated Care Coordinator

Join Our Impactful Team at Health Connect America!

Health Connect America and our family of brands are leading providers of mental and behavioral health services for children, families, and adults across a multi-state footprint. As a COA-accredited organization, we are held to nationally recognized standards of quality, accountability, and best practice in every aspect of care we deliver.

We are relentlessly committed to keeping families together and transforming lives through evidence-informed care, delivered by clinically trained staff who meet clients where they are — in their homes, in their communities, and in our offices. Our work is guided by five core values: client-centered care, empowerment of our people, evidence-informed excellence, a purpose-driven culture, and bold, adaptive leadership.

When you join Health Connect America, you join an organization that invests in you. You'll Grow With Us through meaningful development opportunities,
Be Well With Us through programs that support your whole self, and know that You Belong With Us in a culture built on purpose, compassion, and impact.

Our Brands

The primary responsibilities of the Integrated Care Coordinator are to deliver comprehensive, person-centered care by planning, coordinating, and monitoring individualized treatment plans to align with behavioral health goals. They play a pivotal role in closing gaps, tracking progress, and upholding the highest standards of quality and regulatory compliance. Assist the Nurse Practitioner with clinic appointment related documentation and facilitation on site when working in the clinic.

Additionally, they support marketing initiatives for new referrals and engage in outreach to integrated care attributed members, providing education on our program, and facilitating enrollment.

• Actively engage with individuals through assessment, coordination, health promotion, and transitional care, documenting assessments and coordinating with the care team and treatment teams.
• Provide comprehensive care management, coordination, health promotion, individual and family supports, and referrals to community services.
• Complete the Care Management Comprehensive Assessment within designated time frames and share results with primary care providers and relevant agencies.
• Ensure clients receive required physical exams, medication monitoring, and appropriate services.
• Maintain medical record compliance and ensure timely documentation of care coordination activities.
• Monitor HEDIS gaps and verify client payer and program enrollment status monthly.
• Develop individualized, person-centered care plans incorporating assessment results and Division’s guidelines, focusing on unmet health needs and Social Determinants of Health (SDOH).
• Coordinate follow-up services for recent hospitalizations or life transitions, ensuring smooth transitions of care.
• Identify and provide crisis response as necessary, participate in post-crisis debriefing, and be available for on-call support.
• Communicate effectively with individuals, providers, and natural supports, providing education on services.
• Establish collaborative relationships with care team members and community resources to improve resource linkage and documenting follow-up.
• Support transitions between care settings and develop comprehensive discharge or transition plans.
• Attend Treatment Team and supervision meetings, integrated care team meetings, and serve as a liaison with other professionals and agencies.
• Assist with marketing new client referrals and provide on-call support as needed.
• Review data for service appropriateness and compliance issues.
• Attend training sessions and comply with agency policies and procedures.
• Ensure compliance with all state regulatory…