Integrated Care Specialist
Core
Provides individualized transitional case management for individuals requiring intensive support during transitions from critical events like incarceration, homelessness, or frequent ED visits, connecting them to medical, behavioral, and substance abuse services.
Role type
Senior IC Integrated Care Specialist (Case Management)
Builds
Transitional care pathways and community reentry support for high-need populations
Domain
Healthcare + Social Services (Safety-net/Emergency Medicine)
Required skills
Case management, trauma-informed care, community resource navigation, patient advocacy, interdisciplinary collaboration, care plan execution, enrollment coordination
Preferred skills
Bilingual (English/Spanish), knowledge of Epic EHR, experience with corrections/homeless populations
Technologies
Epic, Microsoft Office
Responsibilities
Execute care management plans and connect patients to outpatient resources; Build rapport and provide trauma-responsive support; Direct selection of goals and interventions based on patient needs; Provide wrap-around services for community transition; Create processes for patient enrollment and departmental connection; Screen and refer patients for substance abuse, mental health, and infectious diseases
Seniority
Mid-Senior level, hands-on IC