Clinical Care Partner - Health Home

Company: Bay Cove Human Services
Location: Boston
Posted on: June 2, 2025

Job Description:

Bay Cove Human Services' mission is to partner with people to overcome challenges and realize personal potential. Bay Cove pursues this mission by providing individualized and compassionate services to people facing the challenges associated with developmental disabilities, mental illness, substance use disorders, and homelessness at more than 175 program sites throughout Greater Boston and Southeastern Massachusetts.
Job Summary:
The Clinical Care Partner collaborates with the clinical team at Bay Cove and with the clinical team at Commonwealth Care Alliance (CCA) in the provision of intensive case management and care coordination for clients with complex behavioral health and medical challenges in order to maximize the integration of medical and psychiatric care for clients. The Clinical Care Partner contributes to Bay Cove's mission by providing the highest quality and continuity of care for members and by partnering with members to work towards their personal goals in order to achieve greater independence and improved quality of life.
This is an exempt position.
Essential Functions of the Position:

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  Acts as a liaison between the health insurer CCA, community providers, and Bay Cove staff by coordinating all aspects of medical and psychiatric care for those receiving services from Bay Cove Human Services that are enrolled in a One Care Plan
  
  
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  Coordinates and facilitates Interdisciplinary Care Team meetings, participates in initial and annual health needs assessments and facilitates the development of an Integrated Care Plan for assigned members
  
  
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  Educates eligible members and industry stakeholders about One Care program benefits, services and supports
  
  
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  Regularly assesses members health status and makes adjustments to their care plan and facilitates access to community services.
  
  
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  Collaborates closely with Primary Care Physicians and other outpatient providers and ensures appropriate referrals based on level of care needed to optimize outcomes and minimize risk
  
  
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  Effectively communicates any proposed changes in services, hospitalizations, medication changes, transitions of care, crisis intervention, and changes in level of care
  
  
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  Supports safe transitions for members moving between care settings, including but not limited to hospital to home, hospital to rehabilitation settings, rehabilitation settings to home, hospital to shelters, and substance abuse treatment programs to community residence programs
  
  
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  Perform other duties, as required.
  
  
  Requirements for the Position:
  
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    Master's degree in social work, psychology, counseling or related field required.
    
    
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    LICSW, LCSW, LMHC, or other behavioral health category which qualifies as Licensed Practitioner of the Healing Arts preferred.
    
    
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    At least two years of experience providing services to adults with mental health challenges.
    
    
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    High degree of personal organization, attention to detail, and time management skills.
    
    
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    Professional writing and verbal communication skills.
    
    
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    Proficiency in word processing and other computer functions using Windows, Word, and Google Email and Apps.
    
    
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    Use of personal cellular telephone for work communication.
    
    
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    Current Massachusetts Driver's License and use of reliable personal vehicle for work related travel
    
    
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    Bilingual candidates encouraged to apply, pay differential offered for candidates with fluency in certain essential languages.
    
    
    Bay Cove Human Services is an Equal Opportunity Employer and does not discriminate on the basis of race, ethnicity, religion, sex, gender identity or expression, national origin, sexual orientation, disability, age, veteran status, or any other groups as protected by Massachusetts or federal law. All qualified candidates, regardless of background, are encouraged to apply.
    
    Bay Cove Human Services does not offer visa sponsorships at this time and will require candidates to be authorized to work in the United States.
    
    #BaycoveBHI

Keywords: Bay Cove Human Services, Fall River , Clinical Care Partner - Health Home, Healthcare , Boston, Massachusetts