About Job

Bilingual Intensive Care Coordinator

STATUS

Full Time

FLSA STATUS

Exempt

DEPARTMENT

InCK

EMPLOYER INFORMATION: Clifford Beers & Urban Community Alliance: A Shared Vision for Community Wellness

Clifford Beers Community Care Center is a trusted mental health clinic serving children and families and proudly serves as the Lead Organization for the Connecticut Integrated Care for Kids (CT InCK) initiative—funded by CMS/CMMI and the Connecticut Department of Social Services. Committed to improving health outcomes across New Haven, Clifford Beers leads the design and implementation of an integrated system of care that addresses mental and physical health, as well as the social determinants that impact well-being and long-term resilience.

In partnership with Urban Community Alliance (UCA), whose mission is to empower youth, engage families, and strengthen communities through culturally responsive, trauma-informed support, this collaboration reflects a shared dedication to equity, healing, and access. UCA’s vision to build resilient, thriving communities aligns seamlessly with Clifford Beers' commitment to transforming systems of care. Together, we work to close health disparities, elevate youth voices, and foster holistic wellness for children and families in historically under-resourced neighborhoods—ensuring that care is not only coordinated, but community-rooted and sustainable.

PURPOSE:

The Intensive Care Coordinator (ICC) position is a direct care position working with families in the New Haven Community to provide wrap-around, trauma informed care coordination. ICCs are a vital member of the Integrated Care for Kids (InCK) system of care in New Haven. The ICC will provide Intensive Care Coordination for members receiving Healthcare for Uninsured Kids and Youth (HUSKY) and Medicaid/CHIP insurance living in specific New Haven zip codes. ICCs serve as a family’s first point of contact and work to engage, educate and empower families to help them address their physical, mental, and social drivers of health needs. Employing a strengths-based approach through a trauma informed, anti-racist lens, the ICC coordinates the member/family healthcare needs through the process of needs assessment, identifying family’s strengths and aspirations and helping link them to human services geared toward achieving positive, holistic outcomes and seamless care integration.

What is InCK CT?

The Integrated Care for Kids (InCK) Model, a federal award obtained through CMS/CMMI, is a child-centered local service delivery and state payment model that aims to reduce expenditures and improve the quality of care for children under 21 years of age, pregnant, and post-partum individuals covered by Medicaid through prevention, early identification, and treatment of behavioral and physical health needs.

This position reports to the Community Engagement and Outreach Manager at Clifford Beers Community Care Center and is an integral member of the Implementation Team.

Core knowledge that is fundamental to the Intensive Care Coordinator (ICC) includes:

Extensive knowledge and experience in Wraparound Care Coordination activities

Knowledge of social services, neighborhoods, political landscape and community stakeholders throughout greater New Haven

Exceptional ability to work in a collaborative environment within multiple organizations Experience working with children and families in need of unique and specialized services including but not limited to physical/medical health, behavioral/mental health, social drivers (determinants) of health, crisis and safety planning for urgent needs.

Demonstrates a family-centered approach, understanding historical and generational trauma rooted in health disparities, using trauma-informed and anti-racist practices

Commitment and practice in cultural humility, diversity, inclusion and belonging within community based efforts

Demonstrates proficiency in documenting in care management technology platforms Flexibility to adapt to the changing/responsive nature of the CT InCK system of care

KEY RESPONSIBILITIES:

Provide the Integrated Care for Kids service model to members and families assigned.
Utilize selected technology platforms for conducting needs assessment, care planning development, referrals and documentation. Maintain policies and standards for data management, privacy and confidentiality, HIPAA, security, and reporting as required to maintain compliance.
Conduct outreach and engagement activities for HUSKY Health member/family including in the members home and settings in the community
The ICC will be the Single Point of Contact for member/family and Care Team (Core Child Services and other providers of choice) Assemble, coordinate and host the ICC Care Team to include identified Core Child Service providers, member/family informal and formal supports, health care providers and practitioners including but not limited to medical/physical, mental/behavioral, dental, specialty care, Ob Gyn, and Community Based Organizations meeting the Social Detriments of Health needs.
Develop, coordinate and manage family-centered Care Plan and Care Team Meetings with members/family using the Intensive Care Coordination model for CT InCK
Participate in scheduled meetings with assigned CT InCK CHO (Community Health Organizer) for quality assurance, monitoring and coaching, community education, training and education, feedback, and reporting.
Participate in scheduled meetings with the Learning Collaborative of CT InCK Providers “System of Care”.
Participate in public and private convening’s that promote learning, collaboration, and equity for members/families and the CT InCK system of care/community as available.
Complete CT InCK Model Training requirements.
Assume primary responsibility for maintaining CT InCK model integrity and fidelity in practice, participation, and purpose.
Maintain a trauma-informed, anti-racist, equity approach to improve the health and well- being of children, families, neighborhoods and community.
Complete all necessary documentation written in a billable and timely manner consistent with all standards and regulations
Other duties as necessary

EDUCATION AND EXPERIENCE:

Bachelor’s degree in Mental Health/related field preferred or relevant lived experience
Community Health Leadership training/completion is a plus
Community Health Worker (CHW) certification is a plus.
Experience working with HUSKY Health CT members and families
Training/Certification in Wraparound Care Coordination model a plus.
Understanding of PCMH+ (Person-Centered Medical Home Plus) Care Coordination model
Commitment to advancing health and well-being for children and families as well as health equity in programs and services.
Knowledge of social services, neighborhoods, political landscape and community stakeholders throughout greater New Haven

SKILLS:

Familiarity with the New Haven community and New Haven area resources
Strong collaboration, organization and community engagement
Proven ability in care coordination, case management, working with children and families
Proven ability in complex problem-solving and critical thinking skills
Comfortable with technology, provider referral and member data systems; experience with electronic health/medical records a plus
Team Management and/or Group Facilitation experience
Documentation and Reporting experience; Tableau experience a plus
Adaptability with cross-cultural and /multilingual community
Strong organizational and time management skills
Self-starter

REQUIREMENTS: