Care Coordinator

Role

The Care Coordinator (CC) is a non-clinical member of FamilyWell’s care team and plays a pivotal role in supporting patients throughout their reproductive journey. CCs also provide program management and logistical support for FamilyWell’s partnering women’s health clinic. This role focuses on care coordination, engagement, and navigation. CCs do not provide therapy, clinical assessment, diagnosis, or medical advice.

CCs guide patients through every step of FamilyWell’s integrated mental health program, working closely with a cross-disciplinary team to ensure seamless communication, timely follow-up, and a consistently positive patient experience. They support patients across a wide range of acuity levels by providing compassionate outreach, coordinating referrals, monitoring progress, and helping patients stay engaged in care throughout their FamilyWell journey.

Key Responsibilities:

Patient Engagement:

• Communicate with patients through various channels (text, phone) to facilitate program engagement, provide reminders, and follow up on care.
• Maintain strong engagement and satisfaction among patients through ongoing support and education

Care Coordination and Documentation:

• Update patient records in Electronic Health Records (EHRs) and communicate care plans to referring clinic partners.
• Maintain a collaborative care registry to track patient follow-up and clinical outcomes.
• Prepare and submit routine progress reports in the EHR.
• Facilitate outside referrals for community-based social services as clinically indicated (e.g., housing assistance, vocational rehabilitation, mental health specialty care, substance abuse treatment).
• Care Coordinators do not handle crisis stabilization independently; they escalate to licensed clinical team members per protocol.

Reporting and Collaboration:

• Compose, prepare, and communicate timely patient and provider responses to questions.
• Report directly to the Lead Care Coordinator and provide regular updates on patient engagement and clinical outcomes.
• Collaborate with OB clinic staff to ensure coordinated care and support for patients.

Qualifications

Education:

• Required: Bachelor’s degree and/or Master’s Degree in nursing, social work or psychology
• Clinical licensure not required for this role

Skills:

• Strong understanding of women’s mental health conditions, treatments, and community resources.
• Excellent communication, organizational, and problem-solving skills.
• Comfortability with managing a high volume caseload of patients across varying acuity levels.
• Ability to engage and educate patients in a compassionate and supportive manner.
• Strong ability to collaborate across departments including Care Operations and Partner Success
• Proficiency in using EHR systems and maintaining accurate patient records.
• Proficiency in using Google Suite.

Key Competencies:

• Empathy and Compassion: Ability to understand and support the unique challenges of pregnant/postpartum patients and patients experiencing menopause.
• Engagement Skills: Proficient in maintaining patient engagement and satisfaction with the program.
• Communication: Strong verbal and written communication skills for effective patient and provider interactions.
• Organizational Skills: Ability to manage patient records, track outcomes, and ensure timely follow-up.
• Cultural Sensitivity: Respectful of diverse backgrounds and experiences, particularly in a perinatal and menopause context.
• Adaptability: We’re a fast-growing company, constantly looking to make improvements as we go. Our team is smart, resilient, and always iterating to make our program even better for our patients.