• Care Coordinator

    Job Locations US-NY-Staten Island
    Position Number
    Pathway to Wellness
    Regular Full-Time
    FLSA Status
    Maximum Salary
    USD $50,000.00/Yr.
  • Overview

    The Care Coordinator functions as a member of an interdisciplinary team to provide care coordination to a caseload of severely mentally ill adults with multiple medical comorbidities and/or co-occurring substance abuse disorders and/or medically ill individuals. Advocates for and supports the client, engages with community agencies/health care providers and others on his behalf to ensure access to services needed to increase wellness self-management and reduce emergency room visits and/ or hospitalizations. Provides clinical support to the Team by providing consultation, education, information around psychosocial and/or substance abuse conditions, interventions, resources to maintain focus on outcomes and best practices.


    • Conducts initial and ongoing assessments of assigned clients to document strengths, needs, goals, and resources.
    • Participates in the development/documentation /review and update of client centered comprehensive integrated, interdisciplinary care plan in consultation with   other team members to ensure focus on desired outcomes.
    • Maintains effective communications with clients, primary care physicians, substance abuse, and mental healthcare providers, family, collateral resources and other Agency staff on behalf of clients.
    • Maintains documents, records, statistics, and other related reports in an organized, timely, and accurate manner as per policy and procedure.
    • Coordinates care planning with other providers of services/ resources to ensure goal directed, collaborative care, including care transitions.
    • Works as part of a Care Coordination team; attends and participates in team meetings to provide input/feedback around psychosocial and medical conditions conditions/comorbidities to review client status, update plans and goals, review outcomes to further program goals.
    • Acts as a resources/consultant to all team members on psychosocial, medical and/or substance abuse issues and resources.
    • Provides telephonic as well as face-to-face outreach, engagement, and service planning in the field.
    • Acts as a linkage to community services including medical, behavioral, residential, entitlement and any other needed services per interdisciplinary care plan.
    • Monitors overall service delivery to clients to ensure coordination and continuity; advocates with service providers/resources as needed.
    • Provides crisis intervention and follow-up.
    • May be assigned other tasks and duties reasonably related to the job responsibilities.
    • And other duties as may be assigned


    1. A bachelor’s degree in one of the fields listed below1; or
    2. A NYS teacher’s certificate for which a bachelor’s degree is required; or
    3. NYS licensure and registration as a Registered Nurse and a bachelor’s degree; or
    4. A Bachelor’s level education or higher in any field with five years of experience working directly with persons with behavioral health diagnoses; or
    5. A Credentialed Alcoholism and Substance Abuse Counselor (CASAC).


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