Under the direct supervision of the Care Coordination Supervisor/LPN, and managed by the Director of Health and Wellness, the Care Coordinator/LPN will perform healthcare coordination and on-site nursing services to HSVS foster care youths living in two group residential facilities in Queens. The Care Coordination team uses a trauma-informed approach to ensure that all children placed in HSVS’s foster boarding homes and group residential settings are receiving all needed medical, dental, behavioral health, and specialty health services through HSVS’s 29-I primary care clinic and Medicaid Managed Care Plan (MMCP) in-network providers, and that these services are being documented appropriately in the NextGen Electronic Health Record (EHR). The Queens Care Coordinator/LPN will be an integral part of this growing Care Coordination team and will also work closely with the department’s Managed Care Liaison team. Clinical oversight will be provided by the Care Coordination Supervisor/LPN, the 29-I RN Supervisor and 29-I Medical Director, as appropriate.

Responsibilities:

 Coordinate all aspects of healthcare services for designated caseload of foster care youths in Queens group “Healing Homes.” Duties include, but are not limited to Act as liaison/point person for healthcare providers, pharmacies, and MMCP case managers Schedule and ensure attendance at medical/dental/behavioral health appointments, per ACS’s schedule of required regular evaluations; help coordinate transportation to appointments as needed Monitor and address youths’ healthcare needs in between routine primary care visits, including facilitating access to urgent care Under clinical oversight by the Care Coordination Supervisor/LPN, obtain and review medical exam records to determine whether further treatment is recommended, including referrals and medications Ensure timely follow-up on referrals, emergency care and hospitalizations Coordinate closely with HSVS’s 29-I clinic, Healing Homes, Case Planning, and Children’s Health Homes teams, as applicable, in the provision of above services and to establish treatment goals Develop a trusting caregiver relationship with the foster care youths Process new intakes upon placement, including required 30-day initial medical, dental, behavioral health assessments, and required timely documentation of Medical Necessity and the Comprehensive Treatment Plan in NextGen EHR Process discharges from Healing Homes, including ensuring timely final discharge medical exam and providing required medical records from NextGen EHR Conduct youth assessments, including HIV, STD, and substance abuse risk assessments, as well as perform general first aid, triage activities, and physical body checks for abuse Routine management and training regarding chronic medical conditions, such as diabetes and asthma Provide health and wellness education and counseling (nutrition, smoking and substance use risks, etc.) Support and manage the emotional/psychiatric needs of the youths Medication administration and management Maintaining medical supplies and equipment Work with Managed Care Liaison team to ensure that healthcare appointments are scheduled with providers in-network with child’s Medicaid Managed Care Plan (MMCP) Ensure family medical history, proper consents (routine, mental health treatment, psychotropic medication, etc.), HIPAA authorizations, and all other required medical record documentation are entered in NextGen EHR Support the completion of twice-yearly adolescent assessments: sexual/reproductive health, gender identity, sexual orientation, and family planning counseling Complete additional required actions in NextGen EHR, including referrals to HSVS’s Article 31 behavioral health clinic, CHH “Warm Hand-offs,” data share reconciliations, etc. Attend trainings as directed. Engage in ongoing review of departmental policies, procedures and practices to make recommendations for quality improvement. Perform other tasks as assigned within the reasonable scope of duties of the position.