Care Coordinator - Primary Care


Bachelor's degree from an accredited university or college with a major in a field related to care managementpreferred.  Experience with direct client contact in a medical or other treatment setting may substitute for educational requirements.


Must possess a valid Class D driver's license and have acceptable driving record as determined by the Human Resources department.  Must possessviable transportation maintained according to manufacturer's specifications, which is covered by personal auto insurance.


Must be able to learn and utilize Meridian's Electronic Medical Record

Must be able to perform and record basic medical testing, including blood pressure / vital signs, blood glucose, body mass index (BMI), and specimen collection

Must have a working knowledge of basic medical terminology (sufficient to read and interpret medical records and prescriber orders)

Must be able to provide education and coaching on a number of medical, psychiatric, and social issues in a culturally competent and effective manner, to individual clients as well as psychoeducational groups.


1.ASSESSMENT-Completes comprehensive assessments, assessing the total needs of the client. Person centered assessments identify client strengths, needs, concerns, and preferences.Inclusive are physical and mental health issues, function levels, behaviors, social, cognitive, environment, spirituality, support systems and finances. Care managers follow clients across settings and work with care managers of specific settings and gather information from appropriate settings within HIPAA guidelines.

2.PLANNING -Establish goals and a care plan reflecting the client's needs, preferences, and available resources

3.IMPLEMENTATION-Coordinates and implements the care plan by referring, educating, negotiating and mediating with client, family, formal and informal providers in order to meet all client needs.

4.MONITORING-Manages and monitors the ongoing provision of and need for direct care and care management including periodic formal reassessments.

5.PROFESSIONAL PRACTICE AND EVALUATION-Ensures professional practice through quality evaluation as evidenced by adherence to standards of practice and ethical guidelines, recognition and respect for diversity, and participation in quality evaluation activities.

6.Performs numerous contacts including home visits, office visits, community provider(s) and visits/contacts with informal supports to monitor progress in implementation of the Care Plan.

7.Prepares and maintains client records and ensures quality of documentation of medical records. 

8.Records electronically every activity engaged on behalf of a client on a daily basis via Progress Notes.

9.Responsible for meeting yearly productivity and revenue goals. 

10.Researches, develops, and maintains a comprehensive list of community resources that includes addresses, phone numbers, and names of contacts for each resource.

11.Helps to enlighten and broaden public awareness about mental illness. 

12.Monitors clients during any admissions to Crisis Stabilization Unit, Psychiatric and Medical Hospital and maintains contact with the facility treatment team in order to develop timely discharge plans.

13.Follows and complies with all center policy and procedures as outlined in the Center-wide procedure manual.

14.Complies with all payors regulatory requirements as it applies to service delivery and documentation. 

15. Maintains compliance in all required center training.

16.Performs other duties as required to meet program and departmental goals and objectives.