Care Coordinator

Job Description

Job Description

About the Role:

The Care Coordinator Transitional Carceral plays a critical role in facilitating the seamless transition of individuals from carceral settings back into the community, ensuring continuity of healthcare and support services. This position focuses on coordinating comprehensive care plans that address both medical and psychosocial needs, reducing recidivism and promoting successful reintegration. The role requires collaboration with correctional facilities, healthcare providers, social services, and community organizations to create individualized transition strategies. The Care Coordinator acts as a liaison to navigate complex systems, advocate for patient needs, and monitor progress post-release. Ultimately, this position aims to improve health outcomes and quality of life for formerly incarcerated individuals through effective care coordination and resource linkage.

Minimum Qualifications:

• Bachelor’s degree in nursing, social work, public health, or a related healthcare field.
• Experience working with justice-involved populations or in transitional care coordination.
• Knowledge of community resources, healthcare systems, and social service networks.
• Strong organizational and communication skills.
• Ability to maintain confidentiality and adhere to ethical standards in healthcare.

Preferred Qualifications:

• Master’s degree in social work, public health, nursing, or related discipline.
• Certification in case management or care coordination.
• Experience working within correctional health or reentry programs.
• Familiarity with behavioral health and substance use disorder treatment services.
• Bilingual abilities or experience working with diverse cultural populations.

Responsibilities:

• Develop and implement individualized care transition plans for clients exiting carceral facilities.
• Coordinate communication and collaboration among correctional health staff, community healthcare providers, social workers, and support agencies.
• Conduct comprehensive assessments to identify medical, behavioral health, and social service needs.
• Facilitate access to healthcare appointments, medication management, housing, employment, and other essential services.
• Monitor client progress post-release and adjust care plans as needed to ensure continuity and effectiveness.
• Maintain accurate and confidential documentation of client interactions, care plans, and outcomes.
• Provide education and support to clients and their families regarding available resources and health management.
• Advocate for clients to overcome barriers related to healthcare access, social determinants of health, and legal challenges.

Skills:

The Care Coordinator utilizes strong interpersonal and communication skills daily to build trust with clients and collaborate effectively with multidisciplinary teams. Organizational skills are essential for managing multiple cases, scheduling appointments, and tracking client progress through complex systems. Problem-solving abilities help navigate barriers such as housing instability, healthcare access, and legal challenges that clients may face. Knowledge of healthcare and social service resources enables the coordinator to connect clients with appropriate supports efficiently. Additionally, cultural competency and empathy are critical in addressing the unique needs of justice-involved individuals and fostering positive outcomes.