Health Home Care Coordinator
Pay: $24.00 – $25.64/hour | Full-Time | Monday–Friday, 9:00 AM – 5:00 PM
Bachelor’s Degree Required
***Must have a car, comfortable being in the field 3-4 days a week, 1 day remote***
Openings: (2 Suffolk) & (2 Nassau)
About Our Client: We are on a mission to ensure individuals facing serious health challenges never have to navigate the system alone. If you’re passionate about breaking down barriers, advocating for underserved populations, and making a real impact in people’s lives, this is the opportunity for you.
About the Role
As a Health Home Care Coordinator, you will serve as a critical link between clients and the services they need to live healthier, more stable lives. This is a hands-on, community-based role where you’ll support individuals through complex healthcare and social systems—meeting them where they are and helping guide them forward.
What You’ll Do
- Support Transitions of Care: Help clients safely transition from hospitals or rehab facilities back into the community
- Develop Personalized Care Plans: Conduct assessments to identify client strengths, needs, and goals
- Coordinate Care: Schedule and connect clients with primary care and behavioral health providers
- Close Gaps in Care: Address missed appointments, medication issues, and unmet needs proactively
- Address Social Determinants of Health: Connect clients to resources such as housing, food, transportation, and benefits (SSI/SSD, SNAP, HEAP)
- Engage in the Field: Meet clients face-to-face in homes, shelters, hospitals, and community settings
- Collaborate Across Teams: Work alongside providers and community partners to deliver person-centered care
- Track Progress: Maintain accurate, timely documentation and monitor outcomes
What We’re Looking For
- Bachelor’s degree in Social Work, Human Services, Psychology, Public Health, or a related field
- At least 1 year of experience providing direct services to individuals with complex needs (e.g., serious mental illness, chronic conditions, HIV/AIDS, or disabilities)
- Strong communication, organizational, and advocacy skills
- Ability to manage multiple priorities in a fast-paced environment
- Comfortable with field-based work and regular travel, including transporting clients when needed
- A genuine passion for supporting vulnerable and underserved populations
Preferred Qualifications
- Bilingual or multilingual skills
- Experience in Health Home, managed care, or integrated care settings
- Knowledge of community resources and social determinants of health
- Familiarity with transitional care (hospital to community)
- Experience with EHR systems or care management platforms
Why Join The Team?
Make a Real Impact
Your work directly improves health outcomes, reduces hospital visits, and helps individuals build more stable lives.
Collaborative, Supportive Culture
Work alongside a team that values mentorship, professional growth, and shared success.
Mission-Driven Work
Every day, you’ll advocate for individuals who need it most—ensuring no one falls through the cracks.
Grow Your Career
Gain exposure to innovative, integrated care models and develop skills that will elevate your career in healthcare and human services.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
*As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient’s residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
