Intensive Care Coordinator (CSSI) Pathways to Success

Position Title: Intensive Care Coordinator (CSSI)

Department: Behavior Health Services

Reports to: Pathways to Success Program Supervisors

Directly Supervises: Pathways to Success Contacts and Referral Sources

Position Objective and Summary:

Under the direction of the of the Pathways to Success Supervisor, Intensive Care Coordinator (CCSI) takes primary responsibility for making the care coordination process happen for children with a mental health diagnosis and their families through the facilitation of Child and Family Team Meetings, coordinating with professionals, and helping the child meet their goals. CCSI is provided to children stratified into Tier 2. Designated CCSI Care Coordinators work with an average of 25 families (based on population) at a time and are never assigned to work with more than 30 families at once.

The CCSI helps the family develop a positive view of their future and learn how to use the strength-based empowerment model to help their child improve functioning in the home, school, and community.

Pathways to Success is a State of Illinois initiative to provide comprehensive care coordination that will enhance access to critical behavioral, medical and social services for children with complex behavioral health challenges. The program utilizes the evidence-informed Care Coordination and Support model. This is a structured approach to care coordination that adheres to required procedures for child and family engagement, individual care planning, identifying and utilizing strengths and natural supports while monitoring progress and fidelity to the required processes. Care Coordinators assist the families in navigating the complex systems of care until they can navigate them on their own.

Essential Functions and Responsibilities:

Monitoring Service Delivery

• Perform outreach & engagement to locate, engage, and educate Pathways youth and their families.
• Using a trauma-informed approach and effectively engaging children/youth with significant behavioral health needs and their family/caregivers to resources within the community for their assigned caseload.
• Provide intensive care coordination: utilize a strengths-based approach to safety planning, development of family team and family support systems, and wraparound planning for the purpose of maintaining children in their homes, schools, and communities.
• Schedule, plan and facilitate Child & Family Team Meetings.
• Builds and maintains knowledge of available community resources and helps to link youth and family to needed supportive services.
• Using a system of care approach, assist families to coordinate services from community resources, placement providers, collateral agencies, the court, and/or other community partners with families, consumers, or patients receiving services.
• Facilitate the creation of safety and crisis prevention plans.
• Collaborate with local MCR agencies (including UCAN’s BHS MCR team) when necessary.
• Utilize UCAN’s BHS Care Coordination Model with every individual and family served.
• Must be organized, able to meet timelines, manage a case load, and be a self-starter.
• Have strong interpersonal skills and the ability to collaborate and partner with families, children/adolescents, and other professionals.
• Maintain caseload of 1:25 (based on population).
• Performs other duties as assigned.

Identifying and Addressing Client Needs

• Effectively applies clinical knowledge to evaluate client situations and needs
• Identifies at-risk clients and behaviors before serious acting-out occurs
• Successfully engages and develops rapport with a wide range of clients
• Structures services in accordance with program expectations.
• Maintains consistency and safety throughout service provision
• Guides to make decisions based on clinically appropriate, best practice, and ethical considerations.
• Completes service documentation in alignment with agency and program core performance standards
• Referral and Linkage to services and supports in the community
• Excellent writing skills in order to complete required documentation
• Prepare detailed documentation of activities including opening and closing electronic records, completing required assessments, creating, and updating Wraparound Plans, writing daily contact notes, and correspondence, etc.
• Provide a high-level of consumer service and consumer engagement.
• The ability to learn through in-person, virtual, and web-based trainings.
• Seeks case consultation.

Quality and Accountability

• Follows all applicable regulatory standards, including but not limited to: COA standards, Pathways to Success {policy and procedure, and Medicaid procedures.
• Clearly documents actions taken (clinical, supervisory, and administrative) in a timely manner and in a format consistent with requirements.
• Ensures that all data entry is complete, accurate and updated a required by program standards.
• Prepares and distributes reports and correspondence in a timely manner.

Team Building and Agency Networking

• Develops and maintains professional relationships with social service and government agencies and private organizations to enhance service delivery and department image.
• Works effectively with others in a multi-disciplinary setting and actively listens to others
• Builds strong interpersonal relationships with service delivery and service coordination and follow up.
• Discusses alternative problem solving and is open to new ideas and ways of doing things
• Shares specialized knowledge and resources with team and other UCAN departments
• Coordinates services with multiple UCAN programs to ensure appropriate services for clients and teamwork between programs
• Plans for client transitions to other UCAN programs to provide seamless transition for clients and a cooperative team process.

Professionalism and Work Conduct

• Behaves with integrity, demonstrates high ethical standards, and displays a positive image of UCAN and Pathways to Success program.
• Acts in a professional manner at all times and maintains appropriate boundaries with clients.
• Demonstrates accountability for results and keeps commitments to others.
• Reports to work, meetings, training, and job related activities prepared and as scheduled.
• Demonstrates openness and respect for cultural and socioeconomic characteristics of clients and coworkers.
• Understands and supports UCAN’s standard of cultural proficiency and strives to meet it.
• Responds to clients and their families, UCAN staff, service providers and other stakeholders in a timely manner and ensures follow up to adequately address their need.
• Maintains personal professional development and appropriate knowledge of client needs and problems for which services are sought. Remains current on service work theory and practice.
• Performs other related tasks as required or assigned.

Education /Job Experience/Certification:

• Bachelor’s or master’s degree in social work, counseling, rehabilitation counseling, vocational counseling, psychology, pastoral counseling, family therapy, education or related human service field; or in any other field with two years of supervised clinical experience in a mental health setting required.
• Professional Licensure/Certifications and Requirements: NONE
• Experience working with Children/adolescents and families is required.
• Experience with care coordination is a plus.
• Excellent communication, organization, presentation and computer skills.
• (including proficiency with Microsoft Office – Outlook, Word, Excel and PowerPoint) as well as other related software.
• Experience with technology for documenting notes, making referrals, and investigating available services.
• Organizational skills and daily work planning.
• Excellent interpersonal and customer service skills.
• Strong written and oral communication skills.
• Problem solving and analytical skills.
• Adherence to ethical practices and procedures.
• Demonstrated cultural sensitivity, humility, and competence.
• Ability to present a positive image of the agency to clients, community and staff.
• Ability to work in stressful situations, handle multiple tasks and projects simultaneously.
• Ability to resolve issues objectively and maintain strict confidentiality.

Special Knowledge and Qualifications:

• Must meet Illinois requirements of a Mental Health Professional or Qualified Mental Health Professional.
• Bachelor's or Master’s Degree in the human service-related field.
• Willingness to become knowledgeable of the communities served in Chicago.
• Personal vehicle, valid driver’s license, insurable driving record and vehicle insurance.
• Experience working in healthcare or social service agencies a plus.