ACCS Discharge and Care Coordinator

ACCS Discharge and Care Coordinator Vinfen - 3.3 Lowell, MA Job Details Full-time $27 an hour 12 hours ago Qualifications First aid High school diploma or GED Driver's License Working with individuals with mental health conditions Data collection Crisis management

Full Job Description Summary:

The Adult CCS (A-CCS) Discharge and Care Coordinator provides case management, discharge planning, and care coordination services for adults receiving short-term community crisis stabilization services. This position plays a central role in helping persons served transition safety and successfully from the Adult CCS unit to the next appropriate level of car and community-based supports. The A-CCS Discharge and Care Coordinator works collaboratively with the multidisciplinary team, referral sources, outpatient and community providers, family members or natural supports when appropriate, and external service systems to identify discharge needs, reduce barriers to community stability, support safety planning and coordinate follow-up services. The role is primarily focused on case management, discharge planning and community linkage, while also contributing to crisis and safety planning throughout the person's stay.

Job Duties and Responsibilities:

Coordinates discharge planning for adults admitted to the Adult CCS unit, beginning at admission and continuing throughout the person's stay. Completes psychosocial and practical needs screening related to discharge readiness, including housing, benefits, insurance, transportation, primary care, behavioral health treatment, substance use treatment, medications, legal issues, and other social determinants of health. Identifies discharge barriers and develop person-centered plans to address them in collaboration with the person served and interdisciplinary team. Coordinates referrals and linkages to community-based services, and supports, including outpatient behavioral health, psychiatry, primary care, substance use services, peer support, recovery programs, case management, shelters, housing resources, public benefits, and other social service agencies. Schedules and confirms follow-up appointments as indicated prior to discharge. Communicates and collaborates with hospitals, emergency departments, outpatient providers, community agencies, managed care entities, and other referral partners to support continuity of care. • Participates in daily multidisciplinary team meetings, case reviews, and discharge planning discussions. • Develops, reviews, and updates safety plans with persons served in collaboration with the clinical team. Supports persons served in understanding treatment recommendations, discharge plans, available services, and next steps after leaving the program. Engages family members, guardians, caregivers, or natural supports, when appropriate and with proper consent, to support stabilization and transition planning. Provides information, education, and resource navigation to persons served regarding community services and recovery supports. Advocates for persons served in accessing medically, behaviorally, and socially necessary services. Maintains timely, accurate, and thorough documentation in the electronic health record, including referral activity, coordination efforts, discharge plans, safety planning, and follow-up arrangements. Tracks referral outcomes, pending needs, and discharge-related tasks to ensure smooth transitions and minimize gaps in care. Participates in utilization review, program quality initiatives, and data collection activities related to discharge planning and care coordination. Maintains professional boundaries and practice in a manner that is person-centered, trauma-informed, recovery-oriented, culturally responsive, and strengths-based. Performs other related duties as assigned.

Knowledge and Skills:

Ability to work in a professional and confidential capacity. Ability to engage adults experiencing behavioral health crises with empathy, respect and professionalism. Ability to collaborate effectively as a member of a multidisciplinary team. Ability to coordinate care across multiple systems, providers, and community agencies. Ability to triage competing priorities and manage time effectively in a fast-paced crisis setting. Ability to communicate clearly, both verbally and in writing. Ability to establish supportive and trusting relationships with persons served and external partners. Knowledge of person-centered, strengths-based, trauma-informed, and recovery-oriented practice. Knowledge of crisis intervention and safety planning principles. Knowledge of community behavioral health, substance use, medical, housing, entitlement, and social service resources for adults. Knowledge of human, legal, and civil rights and the importance of self-advocacy and empowerment. Sensitivity to cultural, religious, ethnic, disability, gender, sexual orientation, and socioeconomic differences. Ability to work independently, use sound judgement, and problem-solve barriers to discharge and community placement.

Typical Requirements:

Experience in behavioral health, crisis services, case management, discharge planning, substance use services, homeless services, or community -based human services. Experience working with adults living with serious mental illness, substance use disorders, and co-occurring conditions. Knowledge of local adult behavioral health and community resource systems. Bilingual or bicultural applicants are encouraged to apply. Preferred /

Required Education:

High school diploma or equivalent required. Bachelor's degree in human services or related field preferred.

Driving Requirements:

May be called on to drive for Vinfen using either a Vinfen van or personal vehicle. - A valid driver's license must be presented at the time of employment. Incumbents must be at least 21 years of age, have maintained a valid US driver's license for at least one year, and must be able to pass a driver's screening background check. If driving, must maintain a safe driving record, which is subject to annual checks. If using a personal vehicle, must possess and maintain adequate insurance.

Physical Effort:

Direct Care Roles - Ability to stand, walk, bend, kneel, stoop, crouch, crawl, climb as this is a very physically active position. Must be able to lift at least 25 pounds using proper lifting techniques or the use of a two-person lift. Ability to operate a computer and other office equipment such as a calculator, copier, and printer. Ability to sit, reach, climb stairs, and maneuver through narrow spaces or hallways. Ability to assist clients with tasks of daily living. Ability to speak, hear, and communicate with clients, staff, and external representatives. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. For positions in day programs or group residences, the ability to assist in routine living activities including cleaning, meal preparation, vacuuming, shoveling, and grocery shopping.

Required Certifications/Trainings:

CPR within 2 weeks of hire, First Aid within 2 weeks of hire