Family Health Center of Marshfield Inc·Rhinelander, Wisconsin
The Care Coordinator provides outreach and service coordination for patients with substance use disorders, acting as a key partner in developing and implementing individualized care plans across various systems of care. This involves serving as the primary contact, conducting needs assessments, facilitating access to medical and community services, and monitoring patient progress.
The Care Coordinator is responsible for providing outreach and service coordination to patients diagnosed with substance use disorders. This role functions as part of a recovery-oriented system of care and works collaboratively with patients, families or caregivers, healthcare providers, and community resources to support the patient’s recovery journey. The Care Coordinator serves as a key partner in developing and implementing individualized care plans, ensuring services are coordinated effectively, and with sensitivity to each patient’s needs. This position requires strong interpersonal and organizational skills, as well as the ability to navigate complex systems of care while maintaining a high level of professionalism, compassion, and confidentiality.
1.
Serves as the primary contact, advocate, and informational resource for patients, providers, family/caregivers, and community partners to ensure coordination of care across systems and services.
2.
Completes assessments to identify unmet health and social needs necessary for developing individualized care plans.
3.
Develops individualized care plans in collaboration with patients, families/caregivers, and providers to address behavioral, psychosocial, environmental, legal, and financial needs.
4.
Discusses treatment options and available resources with patients, families, and care teams; initiates referrals to ensure connection with appropriate services.
5.
Facilitates patient access to medical and community-based services that support identified treatment goals.
6.
Provides emotional support and assists patients and families in developing coping strategies to promote recovery and well-being.
7.
Facilitates multidisciplinary team meetings and communicates with family, friends, and agencies, as authorized, to support care planning.
8.
Monitors patient progress, supports adherence to care plans, coordinates necessary changes, and evaluates care plan effectiveness.
9.
Establishes processes that allow patients and families/caregivers to request desired levels of care coordination support.
10.
Educate patients and families/caregivers about community resources and key issues critical to supporting recovery.
11.
Coordinates and attends meetings with patients, families/caregivers, care teams, payers, and community resources to promote treatment success.
12.
Documents relevant medical, psychosocial, and environmental information, along with services provided, to track outcomes and support effective practice.
13.
Participate in meetings, conferences, and educational seminars to maintain or enhance knowledge and professional standards.
14.
Travels as required to attend meetings, support patients, and fulfill departmental responsibilities.
15.
Maintains strict adherence to scheduled work hours with regular and reliable attendance.
16.
Performs other duties as assigned.
Certifications / Licenses
1. Valid Wisconsin Driver’s License required with an acceptable motor vehicle record (MVR), per FHC guidelines.
A high school diploma or equivalent is required, along with personal and/or professional knowledge of substance use disorders and integrated service delivery systems. Experience with communication, facilitation, and organizational skills, along with proficiency in word processing software, is necessary, while a bachelor's degree in human or social services is preferred.
Market context
In Wisconsin, administration roles in healthcare settings are typically supported by steady demand from clinics, hospitals, and other patient-facing operations that need organized, reliable support. These roles can be competitive because employers often look for candidates with a high school diploma, about 3 years of phlebotomy or related laboratory experience, strong communication skills, and comfort with physical demands and hazardous materials. Review the full posting carefully and compare the listed duties, since the job requirements and benefits here are AI-summarized from the original description to save research time.