Care Coordinator (Opioid System of Care) presso Metropolitan Government of Nashville & Davidson County, TN

About the Department

The Behavioral Health Care Coordinator is responsible for managing and coordinating comprehensive behavioral health services for individuals affected by opioid use disorder (OUD). This role involves assessing client needs, linking them to appropriate mental health and substance use disorder treatment services, and ensuring ongoing support throughout their recovery journey. The Care Coordinator works closely with clients, their families, and community partners to create individualized care plans, monitor progress, and facilitate access to necessary resources, including mental health counseling, medical services, and social supports.

Position Duties

• Client Assessment and Care Planning:
  • Conduct comprehensive behavioral health assessments for individuals impacted by OUD.
  • Develop individualized care plans that address clients' behavioral health, substance use, medical, and social service needs.
  • Collaborate with clients, families, and care teams to identify goals and appropriate interventions.
• Care Coordination and Service Linkage:
  • Serve as the primary point of contact for clients, coordinating services across multiple agencies including mental health, primary care, housing, and social services.
  • Link clients to appropriate behavioral health services, including outpatient counseling, psychiatric care, substance use disorder treatment, and support groups.
  • Ensure timely and efficient referrals and follow-up care, working with providers to reduce barriers to access.
• Client Advocacy and Support:
  • Advocate on behalf of clients to ensure they receive the services they need to achieve stability and wellness.
  • Provide emotional support and guidance to clients as they navigate treatment and recovery.
  • Assist clients in overcoming obstacles such as transportation, insurance, or other access barriers to care.
• Crisis Intervention and Safety Planning:
  • Work with clients who may be in crisis, providing immediate interventions and coordinating care with crisis teams when necessary.
  • Develop safety plans for clients at risk of harm to themselves or others, in collaboration with clinical staff and family members.
• Collaboration and Multidisciplinary Teamwork:
  • Collaborate with healthcare professionals, case managers, peer navigators, and other stakeholders to ensure a holistic approach to client care.
  • Attend case reviews and team meetings to discuss client progress and adjust care plans as needed.
• Monitoring and Documentation:
  • Track client progress, update care plans, and document all services provided in accordance with organizational policies.
  • Maintain client confidentiality and comply with HIPAA regulations at all times.
  • Generate reports on client outcomes, service delivery, and barriers to care as required by the program.
• Community Outreach and Education:
  • Provide education to clients and their families on behavioral health and substance use issues, recovery resources, and harm reduction practices.
  • Engage in community outreach to raise awareness of available services and build partnerships with local service providers.

Minimum Qualifications

Any combination of education and experience that would prepare the incumbent to perform the duties of the position at the appropriate level.  Employees would typically have a bachelor’s degree and some experience in program management or development.

More specific education, experience or certification requirements may be included in the position announcement as vacancies occur.

Experience in case management, behavioral health coordination, or substance use disorder services.

Strong knowledge of behavioral health and substance use treatment modalities, including trauma-informed care and harm reduction strategies.

Other Qualifications

or

One (1) year of graduate study in social work, counseling, or public health may be substituted for one (1) year of experience.

• Excellent communication, organizational, and problem-solving skills.
• Ability to work with a diverse client population and build trusting relationships with individuals from various backgrounds.
• Proficiency in electronic health records (EHR) and case management systems.
• Experience working with individuals affected by opioid use disorder or other substance use disorders.
• Familiarity with local and state resources for behavioral health and addiction treatment.
• Knowledge of motivational interviewing and other client-centered care techniques.