ESWA Long Term Services and Supports - Care Coordinator

At Open Sky Community Services, we open our doors, hearts, and minds to the belief that every individual, regardless of perceived limitations, deserves the chance to live a productive and fulfilling life.

Open Sky is on an anti-racist journey, committed to learning, living, and breathing inclusion, opportunity, diversity, racial equity, and justice for ALL.

At Open Sky, you’ll join over 1,300 compassionate and highly trained professionals who put innovative, evidence-based practices to work in ways that positively impact our communities across Central Massachusetts and beyond.

As a trauma-informed organization, Open Sky strives for transparency and sensitivity to the experiences of those we interact with. Self-care is encouraged, and we are committed to providing a positive work culture that is focused on continuous learning and the value of diverse perspectives.

Open Sky is proud to be an industry leader in pay and benefits. Open the Door to Possibility and begin your career with Open Sky today!

 Benefits of Working for Open Sky Include:

• Excellent Supervision (Individual and Group), Professional Development, and Training Opportunities
• Generous paid time off plan – you start with 29 days (almost 6 weeks!) in your first year, including 12 paid holidays. Increases to 32 days in your 2nd year, and the current maximum is 43 days (OVER 8 WEEKS!)
• We pay for your higher education!  Ask about our Tuition Reimbursement Program, and reimbursement for a variety of Human Services certifications.
• Medical, Dental and Vision Insurance with Prescription Plan
• 403b Retirement Plan with Employer Match
• Life Insurance (100% Employer-Paid)
• Eligible employer for the Public Student Loan Forgiveness Program
• And more! 

Open Sky celebrates diversity and is proud to be an Equal Opportunity Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, veteran, or disabled Veteran status. 

The Central Community Health Partnership is a collaboration of five premier human service organizations in Central Massachusetts that have been selected to provide Behavioral Health Community Partner services and Long-term Services and Supports Community Partner services through the MassHealth program. For people with Long-term Services and Support needs, such as developmental disabilities, finding the right combination of services and knowing how to access them can seem to be an overwhelming task. Central Community Health Partnership stands ready to help MassHealth members with complex needs navigate the confusing array of choices. The vision is integrated care that ensures that every member receives the right care at the right time – making good health and wellness a reality, not a dream. 

The Care Coordinator, in collaboration with the Care Manager and Registered Nurse, will serve as primary point of contact by providing outreach, engagement, assessment and person-centered treatment planning for individuals enrolled in the CCCHP's Long Term Support Services Community Partners Program. The Care Coordinator will perform outreach and engage with individuals who are eligible for the care management program within prescribed timelines and will assist member in navigating the network of community-based services and information. They will schedule and conduct in-person assessments within prescribed timelines and maintain contact on a regular basis in accordance with contractual requirements and individual needs.

Other Key Responsibilities:

• Participate in the development and implementation of program goals, objectives, and work plan tasks that are directed toward accomplishing the Mission and Vision of the CCHP.
• Utilize person-centered framework to identify the enrollee’s and/or caregiver’s goals, preferences, desired level of involvement and address any cultural considerations or interpreter services needed.
• Coordinate access to services/fulfillment of integrated health needs with providers including Specialists, Primary Care Physician, Social Service Agencies, and others as directed by the care plan. Coordinate communication between the member or designated representative and member’s healthcare providers.
• Interface with enrollee’s referral agency, specialists, behavioral health, medical providers, and other collaterals to gather information (including all existing medical, behavioral health and treatment plans) to create a comprehensive and person-centered Integrated Treatment Plan (ITP).

• High School Diploma, GED or equivalent, required.
• Valid Drivers License, reliable transportation and acceptable driving record, required.
  
• Previous experience in community-based behavioral health support programs as a community health worker, peer specialist, or recovery coach, required.
• Previous experience working with adults with mental illness/substance use disorders, experience with accessing local resources, navigating health, behavioral health, and/or substance abuse treatment systems.