As a Jail Liaison Care Coordinator this position provides person centered care transitions and care coordination support of individuals who have been detained. This position works with the jail’s behavioral health and medical staff to evaluate the needs of the individual for successful transition into the community to prevent future detainment or incarceration. This position collaborates with the primary care manager supporting the individual in the community to ensure ongoing success in supporting the care plan developed prior to release.
This is a full-time hybrid opportunity. While there is no routine expectation to work onsite, the selected candidate must be available to report to the Alliance Home Office in Charlotte, North Carolina, for business meetings as needed. In addition, the successful candidate will be required to travel to Mecklenburg County detention facilities up to three times per week to meet with members as necessary.
Responsibilities & Duties Assessments Meet with member in-person in the jail setting Document consent to participate with care coordination and release planning Obtain necessary releases of information for coordination of care and collaboration for successful release to prevent future encounters with the justice system Complete an assessment of the individuals physical, psychological, social, environmental, and spiritual needs Provide education and supports to members and legal guardians regarding their rights and responsibilities, available service options, providers availability, and payer requirements With appropriate consent, as applicable, collaborate with formal and informal caregivers or support network, providers, and others in the member’s interdisciplinary healthcare team to inform the assessment During member engagements and through available data related to resource utilization and quality metrics, monitor the member’s condition and response to the care plan and interventions Document the assessment findings, including not limited to, the member’s support systems (professional and informal), primary concerns, strengths, priorities, care need gaps, social needs, goals, etc.
Document member and/or LRP agreement regarding the identified care needs, opportunities, and goals for intervention identified through the assessment Actively collaborate with the individual, jail professionals, and providers to develop a transition plan that adequately address barriers to prevent future encounters with the justice system Care Planning Based on assessment and member identified priorities, develop a member centric and agreed upon care transition plan in collaboration with appropriate and applicable formal and informal caregivers or support network, providers, and others in the member’s interdisciplinary healthcare team Use of a member-centric, collaborative partnership approach that is responsive to the individual member’s culture, preferences, needs, and values Develop care plan with a comprehensive, holistic, and compassionate approach to care delivery that integrates a member’s medical, behavioral, social, psychological, functional, and other need Consideration for the member’s care needs, barriers, and opportunities in development of the care plan In collaboration with the member and their support network (formal and informal) include prioritized goals and outcomes to be achieved with associated interventions or actions needed to reach the goals Include appropriate, relevant, and realistic goals to align with member needs and priorities Care Coordination & Collaboration Facilitating awareness of and connections with community supports and resources Referral to community & social support services, including providing referral, information, and assistance and follow-up in obtaining and maintaining community-based resources and social support services while providing comprehensive assistance securing key health-related services (e.g., filling out and submitting applications) Foster safe and manageable navigation through the healthcare system to enhance the member’s timely access to services and achieve desired outcomes Coordinate care, services, resources, and health education specified in the planned interventions Provide evidence of facilitation, coordination, and collaboration to support transitional care management activities.
To include, not limited to, scheduling transportation, outpatient provider appointments and in-home services for timely access at time of release Facilitate and coordinate with connection to community, local and state resources, primary care providers, members of the interdisciplinary healthcare team, and other relevant stakeholders Document the collaborative and transparent communication with the healthcare team members Conduct telephonic post release follow up with member to proactively address barriers to member adhering to the care transition plan Ensure member connection to ongoing care management engagement and support Advocacy Document adherence to member privacy and confidentiality mandates during all aspects of facilitation, coordination, communication, and collaboration within and outside the member’s primary setting of care Provide education and guidance on self-determination and self-management.
Promoting informed and shared decision-making, autonomy, growth, and self-advocacy Connect the member and/or their informal caregiver supports to education and training to help the member improve function, develop socialization and adaptive skills, and navigate the service system Providing information to the member and their caregivers regarding their rights, protections, and responsibilities, including the right to change providers, the grievance and complaint resolution process, and fair hearing processes Educate other healthcare and service providers in recognizing and respecting the member’s needs, strengths, and goals Recognize, prevent, and eliminate disparities in accessing high-quality care Advocate for the least restrictive appropriate levels of care, timely and well-coordinated transitions, and allocations of resources to optimize outcomes Identify system barriers to quality care, timely and appropriate services, in the least restrictive setting, escalating identified barriers to direct supervisor for additional support Recognize potential rising risk or escalation and seek appropriate consultation with clinical operations and leadership such as, not limited to, medical directors, registered nurses, pharmacy, legal, compliance, organizational senior leadership, etc.
Actively participate in interdisciplinary care team rounds, peer conferences, ad hoc staffing, high-risk member committee, and other consultations as appropriate to the member’s needs and circumstances Professional Accountability Conduct self in a professional manner to align with Alliance values Document in accordance with documentation guidelines, demonstrating adherence to regulatory and organizational standards Accountable to meet performance and productivity expectations and metrics Timely routine/ongoing and ad hoc member outreach and engagement according to standards and to meet the member’s needs Complete assessments and care planning within timelines and based on triggering events/change in circumstances Complete appropriate professional development to obtain and/or maintain required licensure and/or certifications Pursue professional knowledge, practice excellence, and maintain competence in case management and health and human service delivery standards and best practices Maintain compliance with federal, state, and local rules and regulations and organizational, accreditation, and certification standards Demonstrate knowledge, skills, and competency in applying case management standards of practice and relevant codes of ethics and professional conduct Travel Travel between Alliance offices, attending meetings on behalf of Alliance, participating in Alliance sponsored events, etc. may be required Travel to meet with members, providers, stakeholders, attend court hearings etc. is required Minimum Requirements Education & Experience Required : Must meet North Carolina’s definition of a Qualified Professional (QP) per 10A-NCAC 27G .0104 Bachelor’s degree in human services or other related field and two (2) years post-graduate degree accumulated experience in behavioral health or justice involved systems.
Or Bachelor’s degree in a non-human service or other related field with four (4) years post-graduate degree accumulated experience in behavioral health or justice involved systems and at least one (1) year of experience in a healthcare setting with an integrated whole person care model (inclusive of both physical and behavioral health) or working with adults involved with the justice system. Or Master’s degree in a human service field with one (1) year post-graduate degree accumulated experience in behavioral health or justice involved systems Preferred : Certified Care Manager (NACCM, CCMC, or ACCM) Criminal Justice Counseling Professional, Justice-Involved Care Life Coach, or like certification in criminal justice counseling/coaching.
Knowledge, Skills, & Abilities Knowledge of resources and systems in the community that can assist with eliminating SDOH barriers to treatment and whole person living. A high level of diplomacy and discretion is required Problem solving, negotiation, arbitration and conflict resolution skills Must be highly skilled at shifting between macro and micro level planning Detail oriented Ability to organize multiple tasks and priorities, and to effectively manage projects from start to finish.
Work activities and quickly adapt to mandated changes and priorities within the department. The ability to change the focus of his/her activities to meet changing priorities. Proficiency in Microsoft Office products (such as Word, Excel, Outlook, PowerPoint, etc.) is required.
Employment for this position is contingent upon a satisfactory background and MVR (Motor Vehicle Record) check, which will be performed after acceptance of an offer of employment and prior to the employee's start date. Salary Range $29.54-38.40/Hourly Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity. An excellent fringe benefit package accompanies the salary, which includes: Medical, Dental, Vision, Life, Long Term Disability Generous retirement savings plan Flexible work schedules including hybrid/remote options Paid time off including vacation, sick leave, holiday, management leave Dress flexibility Education Bachelors (required)