Care Coordinator Niagara and Erie County

Organization: Horizon Health Services

Location: Tonawanada, NY

Horizon Health Services is a not-for-profit corporation in Western New York that provides hope and healing for individuals and their families dealing with substance use and/or mental health disorders. Horizon is committed to its community and its staff in the knowledge that a team of highly contented, highly trained and dedicated care givers is required to provide the highest quality, most effective, and empathetic treatment and recovery services to those in need. For more than 40 years, Horizon has remained constant in its commitment to be progressive and independent, and to seek out the best clinical and operational practices, emerging technologies and new strategies to help patients and their families. For ten consecutive years Horizon has been named one of the 50 Best Companies to Work for in New York State. Our sincerest appreciation to our employees, patients, families and community members who have the continued strength to work alongside our mission, Together for Recovery.  Changing Lives.  Saving Lives.

Duties and Responsibilities

The Care Coordinator position provides community based services which involve the following:

  • Provides comprehensive care management for a caseload of approximately 60-70 patients, which includes a minimum of one monthly contact to the patient and a provider or family member. Additional contacts may be necessary and is at the discretion of management
  • Completes comprehensive assessment of patient’s needs
  • Develops comprehensive care plans utilizing EMR (electronic medical record)
  • Care coordination and health promotion
  • Comprehensive transitional care from inpatient to other settings, including appropriate and timely post discharge follow up and attending discharge meetings
  • Individual and family support, which includes authorized representatives
  • Referral to community and social support services
  • The use of HIT (Health Information Technology) to link services, as feasible and appropriate. These may include HEALTHeLINK, EPACES, PSYCKES, and Health Commerce System.
  • Improves patient outcomes by addressing primary medical, specialist and behavioral health care through referrals and linkages to appropriate providers
  • Works with patient’s providers to customize services to best meet members’ needs within the parameters of available services.
  • Meets with patient, primary care and behavioral health providers, and other staff as needed to develop and coordinate treatment plans; meets with patient family members if needed.
  • Assists patients in applying for benefits including temporary assistant, SNAP benefits, VA,  and Social Security benefits
  • Assists patients with:
    • Setting up Medicaid transportation and
    • Providing direction transportation if necessary
    • Locating housing if needed
  • Completes documentation that includes:
    •  Maintaining a daily log of contacts for billing purposes
    • Progress notes daily on all contacts in the EMR
    • Completes other paperwork as needed including court reports, consents, etc.

Basic Knowledge/Skills/Abilities

  • Case conceptualization and documentation skills
  • Ability to interact with community providers and colleagues in a professional manner
  • Proficient and able to utilize current technology including Microsoft Office, Excel, Outlook, Electronic Medical Records, Smart phones and laptop
  • Able to prioritize tasks efficiently
  • Able to work well with others
  • Ability to work independently


Must possess a clean NYS driver’s license and have reliable transportation
Vehicle must not have advertisements covering it for another business

Education & Experience:

Bachelor’s Degree in Social Work, Psychology, Sociology, Counseling, Rehabilitation or other Human Services related field with at least 2 years’ experience providing direct care to individuals with a behavioral health diagnosis


Master’s Degree in a Human Services related field with minimum 1-year experience direct care to individuals with a behavioral health diagnosis

You will not be considered for this position if you do not meet the minimum education and experience requirements.


1000 Young Street, Tonawanada, NY

Position Hours

Monday-Friday 8:00 a.m. 5:00 p.m.