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Job Title: Integrated Care Coordinator

Reports To: Behavioral Health Provider/ Director

Classification: Exempt

Supervises: As Directed

Primary Function:

The Integrated Care Coordinator is part of the person-centered multidisciplinary team and provides direct and indirect services to persons served in the medical, dental, and behavioral health departments. The care coordinator supports improved patient health outcomes, increased overall patient satisfaction, and stronger operational and fiscal capacity of the health center.

Essential Duties and Responsibilities:

Functions as a part of a multi-disciplinary team, including the psychiatric providers, medical providers, dental providers, psychotherapists, nurses, patient care technicians, and other support staff.

Case Management:

Complete assessments

  • Individual (adult/child), couples, and family consultation for brief assessment and behavioral interventions
  • Collect thorough social histories, assessments, screening tools
  • Identifies gaps in services and care

Comprehensive care planning

  • Implements evidence-based practice interventions to adults, children, and families based on need.
  • Transitional care coordination (from ER/Inpatient back to the community)
  • Referrals for treatment both internally and externally
  • Connect patients with community resources
  • Ensure Release of Information forms are completed for all external communications


  • Tracks and reviews case progress
  • Facilitates regular treatment planning meetings with providers and staff members
  • Attends staffing meetings with area healthcare partners


  • Complete all charting as needed, including assessments and care plan documentation

Crisis intervention:

Be immediately available to the health center staff during working hours in the event of a psychiatric emergency. Participate as a member of the interdisciplinary team in the event of any kind of psychiatric emergency.

Other Responsibilities:

  • Develop and maintain procedures, protocols, and paperwork/forms on an ongoing basis to ensure the programs relevance and usability to patients and clinic staff.
  • Learn and become proficient with our Electronic Health Record System
  • Track quality health indicators
  • Be knowledgeable of community resources.
  • Facilitate ongoing communication and foster positive working relationships with community agencies.
  • Maintain documentation of referrals to outside agencies
  • Will seek culturally competent services and service providers to meet the unique cultural needs of each agency consumer and family members
  • Stay abreast of therapeutic techniques and best practices in the field.
  • Understanding and knowledge of insurance terminology
  • A thorough understanding of Iowa Medicaid, Medicare, and commercial insurance carriers’ policies, regulations, and enrollment requirements.
  • Ability to successfully pass the training and exam requirements of becoming a Certified Application Counselor (CAC) for UCHC.
  • Ability to successfully complete all required and applicable federal and/or state consumer assistance training; obtain license as a Marketplace Enrollment Specialist
  • Educate our patients in understanding the insurance programs available to them
  • Works in coordination with Financial Counselor and assists with Sliding Fee applications.
  • Assist with special projects as directed
  • Other duties as assigned by supervisor


  • Demonstrates an understanding of the importance of the UCHC Mission Statement in performing all aspects of this position.
  • Adheres to UCHC Standards of Behavior
  • Adheres to UCHC policies, procedures, and guidelines.
  • Maintain infection control and safety guidelines.
  • Maintain confidentiality regarding UCHC, its clients and employees.
  • Practice within scope of license and experience.
  • Maintain a friendly, respectful, and professional environment for all client contacts.
  • Excellent communication skills and be able to work with a diverse group of people
  • Maintain awareness and respect for cultural needs of clients
  • Maintain a cooperative, helpful work environment within the clinic.
  • Attend all mandatory programs, in-service and staff meetings
  • Participate in committees within the center and community outreach events
  • Be flexible to the changes with this expanding role
  • Maintain good attendance record, keeping absenteeism at a minimum
  • Participate in training and education to foster continued professional growth and assure high quality care delivery
  • Attend all mandatory programs, in-service and staff meetings
  • Participate in committees within the center and community outreach events
  • Be flexible to the changes with this expanding role

Environmental/Working conditions:

Combination of office and exam settings. Frequent exposure to communicable diseases, toxic substances, medicinal preparations, and other conditions common to a clinic environment.

Physical/Mental Requirements:

Varied activities including standing, walking, reaching, bending, lifting. Requires standing and walking for extensive periods of time. Occasionally lifts and carries items weighing up to 30 pounds.

Interpersonal Skills:

Courteous, friendly, compassionate, tactful, nonjudgmental, and strong communication skills. Demonstrate ability to motivate and influence others, to obtain cooperation, and to work as a team member and leader.

Other Skills:

Use of computer, printer, office equipment and keyboarding skills.


Minimum of 1-year professional experience,


Bachelor’s Degree from accredited school of Social Work or Nursing (Or equivalent experience in these fields)

Preferred Qualifications:

  • Valid driver’s license
  • Valid Iowa RN license
  • BLS Certification
  • Bilingual, preferably Spanish speaking
  • Experience working in a Federally Qualified Health Center (FQHC)


This description indicates in general terms the type and level of work performed and responsibilities held by the employee. Duties described are not to be interpreted as being all-inclusive.