The AIM Center Inc. Connected Care Coordinator Chattanooga, TN · Full time

Apply for Connected Care Coordinator

AIM Center offers employment, education, housing, socialization, and wellness opportunities for adults living with serious mental illness. We are non-medical and non-clinical; however, we work with other mental health professionals to provide comprehensive mental health services. Using the Clubhouse model of psychosocial rehabilitation, AIM Center empowers participants, our members, to develop relationships and create individualized plans for recovery while working side-by-side with other members and staff to accomplish the work of the Clubhouse. AIM Center has been helping adults in the Chattanooga community lead fulfilling and productive lives while successfully managing their mental health since 1989. Membership is open to people ages 18 and older diagnosed with serious mental illness. Recovery is a lifelong process and the philosophy of our Clubhouse is “Once a Member, Always a Member.” We are a private, non-profit organization supported through foundations, public and private grants and donations. Our Clubhouse is also a TennCare provider. AIM Center is the only psychosocial rehabilitation facility accredited by Clubhouse International and licensed by the State of Tennessee.

The Connected Care Coordinator is responsible for coordinating and advancing access to integrated health and social support services for AIM Center members and community participants. This role ensures that individuals receive timely, person-centered care by identifying needs, removing barriers, and connecting them to medical, behavioral health, and community-based resources that support long-term stability and wellbeing. 

This position requires a balance of responsiveness and structure, combining real-time problem solving with consistent follow-through and documentation. The Connected Care Coordinator plays a critical role in strengthening continuity of care, building trust with participants, and maintaining strong relationships with community partners to ensure effective service delivery. 

The successful candidate will demonstrate sound judgment, strong organizational skills, and the ability to manage multiple priorities in a dynamic environment. They will take ownership of their work, maintain clear and professional boundaries, and approach each interaction with empathy, accountability, and respect. A commitment to AIM Center’s mission and the Clubhouse model, including working with community members in meaningful, collaborative ways to support members’ recovery, is essential to success in this role. 

SALARY AND SCHEDULE 

Salary: $22.00 per hour 

Schedule: Full-time, non- exempt 

Working hours are 8 AM to 4 PM Monday to Friday with occasional weekends and late evenings to support event or program advocacy needs.  

This position is divided between office-based participant services and community-based work. The work week is 37.5 hours; because this position may require work in the evenings or on weekends, the schedule may be flexible as needed and as approved. 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO: 

Care Coordination & Support 

• Conduct comprehensive assessments and intake procedures to identify individual needs, preferences, and barriers to care. 
• Develop and maintain person-centered care plans that integrate clinical and non-clinical services. 
• Utilize motivational interviewing and solution-focused approaches to support behavior change. 
• Monitor progress, provide follow-up support and adjust support plans as needed for each individual within the Connected Care program. 
• Engage families and natural supports, when appropriate. 
• Connect individuals with medical, behavioral health, dental, vision, food, housing, utility, transportation and other community-based resources.  
• Provide timely follow ups and reminders to each program participant as applicable. 

Access to Care & Resource Navigation 

• Coordinate access to medical and mental health providers for the treatment and support of individuals within the Connected Care program. 
• Connect individuals to community resources including food access, social services, etc. as appropriate for the individual's needs. 
• Provide transportation support as needed to ensure access to essential services to participants of the Connected Care program. 
• Support individuals through transitions of care, ensuring continuity and follow-through 
• Build and maintain relationships with community partners to strengthen referral pathways for individuals in the Connected Care program and the AIM Center. 
• Lead in coordinating opportunities such as: vaccination clinics, blood drives, mobile mammography, lung screening, dental clinics, vision services, health screenings, health education, and other preventive-health initiatives. 

Documentation, Compliance & Data Tracking 

• Maintain timely, accurate and complete documentation of all services, assessments, and follow-ups. 
• Track participation progress, support program data collection, and reporting methods with compliance of grant and organizational requirements. 
• Ensure compliance with HIPAA, Medicaid requirements, and AIM Center policies and procedures at all times. 
• Safeguard all protected health information with strict confidentiality at all times. 
• Represent AIM Center with professionalism in appearance, communication and conduct at all times. 

Community Engagement & Partnership Development 

• Establish, maintain and actively strengthen relationships with community partners including healthcare providers, behavioral health agencies, organizations and social service providers while working in conjunction with the Development & External Affairs Team. 
• Serve as the primary liaison between AIM Center and external health care systems to ensure coordinated, continuous support for individuals served and data collection.  
• Proactively and strategically identify and cultivate new community partnerships to expand access to services aligned to address goals, service gaps, the needs of the people served and the organization.  

 

EDUCATION, JOB QUALIFICATIONS AND SKILLS REQUIRED 

• Bachelor’s degree in social work, social services or a related field, or equivalent experience 
• Ability to work independently and meet deadlines, while contributing collaboratively to a small, high-performing team. 
• Strong interpersonal skills with attention to detail. 
• Ability to communicate effectively and professionally.  
• Ability to establish and maintain professional boundaries. 
• Proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint, Teams, etc.)  Experience in electronic health records or other database systems is a plus 
• Must possess reliable transportation, a valid automobile insurance and driver’s license with an acceptable driving record and have the ability to obtain a Tennessee F endorsement as required. 
• Bilingual in English and Spanish or another language is strongly desired 
• Experience in a nonprofit or community-based setting is preferred 
• Experience in mental health or behavioral health services is strongly desired 
• Support a safe, inclusive, and culturally responsive environment. 
• Ability to understand, follow, and uphold all AIM Center, Inc. policies and procedures. 
• Other duties as assigned.