Care Coordinator RN (54746)

POSITION SUMMARY:

The Registered Nurse (RN) Care Coordinator plays a critical role in supporting integrated, whole-person care within a Certified Community Behavioral Health Clinic (CCBHC). This role involves coordinating behavioral and physical health services, collaborating across disciplines, and ensuring timely care through the management, scheduling, and tracking of referrals. The RN Care Coordinator empowers clients by helping them navigate systems of care and achieve optimal health outcomes, while also providing clinical oversight and guidance to Licensed Practical Nurses (LPNs) working within the CCBHC.

DUTIES AND RESPONSIBILITIES:

• Conduct comprehensive nursing assessments and screenings for physical and behavioral health needs.

• Administer and monitor psychiatric medications, including injections, and observe for therapeutic effectiveness and side effects.

• Provide education regarding medication benefits and side effects.

• Collaborate with behavioral health clinicians, primary care providers, peer specialists, and other care team members to develop and implement individualized care plans.

• Educate clients and families about psychiatric diagnoses, symptom management, coping strategies, medications, and treatment options.

• Monitor and coordinate care transitions across settings (e.g., hospital discharges, inpatient psychiatric stays, referrals to specialists, etc.).

• Initiate, schedule, and track internal and external referrals for specialty care, social services, housing, substance use treatment, and other supports as identified in the client’s care plan.

• Follow up on referrals to ensure services are accessed, completed, and integrated into the client’s ongoing treatment.

• Maintain and update a database or directory of community partners and referral sources.

• Serve as a liaison between the clinic, clients, and external service providers to ensure smooth communication and care coordination.

• Assist clients and families with understanding referral instructions, scheduling appointments, and removing barriers such as transportation, insurance, or paperwork.

• Monitor outcomes of referrals and document follow-up activities in the electronic health record (EHR).

• Identify social determinants of health and connect clients to relevant community-based services.

• Participate in interdisciplinary team meetings to review care progress, referral completion, and evolving client needs.

• Ensure compliance with CCBHC standards, HIPAA regulations, and clinic protocols.

• Provide clinical oversight, delegation, and guidance to LPNs in accordance with Kentucky Board of Nursing regulations, ensuring quality of care and adherence to scope of practice.
• Review, co-sign, and provide feedback on LPN documentation and interventions as required.

*Other duties as assigned by supervisor.

QUALIFICATIONS:

• Education: Associate or Bachelor’s Degree in Nursing from an accredited program.

• Experience: Minimum 2 years of experience in nursing; behavioral health, psychiatric, community health, or case management experience preferred. Experience working in integrated care or CCBHC models preferred.

• Knowledge of trauma-informed and recovery-oriented care practices.

• Proficiency in EHR systems and referral tracking software.

LICENSURE/CERTIFICATION:

• Licensure: Active and unrestricted Registered Nurse (RN) license in Kentucky or Compact State.

• Certifications: BLS/CPR certification

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JOB REQUIREMENTS / EXPECTATIONS:

• Strong organizational and follow-through skills to manage multiple referrals simultaneously.

• Excellent communication and interpersonal abilities.

• Ability to work collaboratively in interdisciplinary teams and across care settings.

• Cultural competence and a commitment to equity and inclusion.

• Skilled in motivating and educating clients on accessing healthcare and support services.

•Work is performed in a standard office and clinical setting, with occasional travel to partner sites or client locations.

• Must be able to sit, stand, and use a computer for extended periods.

Provides clinical oversight and guidance to Licensed Practical Nurses (LPNs) within the CCBHC.

CORE VALUES:

All employees must be willing to live our company's core values.

• Integrity – Exhibiting the highest moral, ethical and legal standards. Doing the right thing – even when no one else is looking.
• Teamwork – Putting team success over personal success. Actively valuing the strengths and talents of others.
• Trust/Respect– Seeing and believing in the good intentions of others. Interacting with others in a way that makes them feel valued. Listening without judging. Offering understanding and acceptance.
• Care/Compassion – Demonstrating unconditional kindness, concern and empathy. Exhibiting genuine concern for others.
• Ownership/Accountability – Taking personal responsibility for one’s work, actions and feelings. Accepting responsibility for and learning from mistakes.

Salary : $71,000