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Evergreen Health Case Coordinator in Buffalo, New York

Pride Center of WNY

The Case Coordinator will be responsible for conducting outreach, engaging participants, facilitating groups, linking clients to services, and coordinating peer support under the Methamphetamine Overdose Prevention Program. The program focuses on services for Men who Have Sex with Men (MSM) of color who use drugs, specifically methamphetamines. The Case Coordinator will apply the essential activities of case management including assessment, planning, coordination, monitoring, and evaluation of clients seeking services under this initiative, as well as providing referrals and linkage to additional community supports as needed. Engages and builds rapport with clients, establishing regular contact to assist clients with action steps toward reaching their goals.

As part of the essential functions the Case Coordinator:

  • Engages and builds rapport with clients, establishing regular contact to assist clients with action steps toward reaching their goals. Achieves monthly productivity expectations.

  • Completes a comprehensive assessment within 1 week of client’s enrollment into the program and provides referrals applicable to the client’s needs.

  • Completes individualized client-centered action plan with the client within 60 days of enrollment and follows-up monthly to identify needs and goals.

  • Develops person-centered and harm-reduction based action plans to promote progressive movement towards clients’ goals.

  • Coordinates and facilitates and or co-facilities support groups.

  • Works collaboratively with designated representatives of the Center for Behavioral Health on patient specific needs, as well as identifying tends in the affected community (e.g. loneliness, intimacy issues, stigma, etc.)

  • Provides case management for target population, to make appropriate and necessary service linkages (e.g., medical, legal, housing, social, financial, transportation).

  • Represents patient when advocacy is necessary.

  • Assist target population in addressing comorbidities and linking to necessary services.

  • Assist target population with navigating coverage with insurance providers (like Medicare and Medicaid) to receive necessary medical services as applicable.

  • Coordinates with multidisciplinary team on clients action plan, including but not limited to primary and specialty care, behavioral health care, and supportive services applicable to the clients’ continuity of care.

  • Conducts diligent search activities to ensure patient engagement and to assess on-going emerging needs to promote continuity of care and improve health outcomes.

  • Maintains complete, current, and accurate patient files that comply with agency confidentiality policies.

  • Form community partnerships with substance use providers, peer driver organizations, popular opinion leaders within the methamphetamine/ chem sex communities.

  • Tracks all referrals and linkages to treatment and other supportive services. Collects and reports program data required by funding source.

  • Conducts annual case review with Program Director and other applicable providers within the agency to monitor and evaluate patient status and outcomes.

  • Completes documentation of services and encounters within 48 hours of delivery in accordance with agency and funder guidelines.

  • Provides guidance when available to other Pride Center staff working with clients requiring additional supports.

Qualified Candidate will have a Master’s degree in social work or counseling with two (2) years of field experience in case management, mental health, and/or substance use. Valid licensure or certification (LMSW, LCSW, LMHC, CASAC, or CRPA) preferred. Candidate must be able to communicate clearly and professionally and demonstrate ability to work independently and exercise effective multitasking and time-management skills. Candidate will have excellent interpersonal and customer service skills. Proficient with Microsoft Office Suite or related software. Ability to maintain Protected Health Information (PHI) in a confidential manner required. Sensitivity toward cultural diversity, people living with HIV/AIDS and lifestyle and addiction issues essential.

Job Type: Full Time

Required Education/Experience: Master’s degree in social work or counseling with two (2) years of field experience in case management, mental health, and/or substance use. Valid licensure or certification (LMSW, LCSW, LMHC, CASAC, or CRPA) preferred.

Required skills/abilities: Valid drivers license and ability to travel between offices/clinic locations and or other destinations as necessary

Preferred Experience: Experience working in a non-profit setting.

What Evergreen Health Offers You:

  • Multiple comprehensive medical health insurance plans for you to choose from

  • Dental and Vision coverage at no cost to you

  • Paid Time Off package that equals 4 weeks of time in your first year

  • 403b with a generous company match

  • Paid parking or monthly metro pass

  • Professional development opportunities

  • Paid lunch breaks

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