Care Coordination

At Evergreen Health, we understand how overwhelming the health care system can feel, and we want to make accessing care easy for you. With Care Coordination, a case worker will help you find the services you need to live your healthiest life. Care Coordination is offered in our Buffalo and Jamestown health centers.

What do care coordinators do?

Care coordinators help you create a care plan by reviewing your needs and health goals. They make sure that your doctors, specialists and providers are communicating with each other about your unique needs. Care coordinators also help you navigate the healthcare system —from finding providers and scheduling appointments to arranging for additional needed services —to ensure you have what you need to follow your care plan.

Care coordinators assist with things like:

• finding a doctor or specialist
• making sure doctors are talking to each other about your care
• advocating for you
• helping you understand and remember confusing information
• scheduling appointments, tests and more
• getting transitional care after discharge from the hospital
• getting into mental health or substance user health programs
• linking with transportation resources

Care coordinators can also help you access and enroll in other social services you may be eligible for.

Care coordinators will help you:

• apply for financial services and entitlements through DSS, SSA, HEAP and more
• find education or job training programs
• get nutrition counseling and food pantry items
• link with housing assistance programs
• access additional community and social support
• prepare for life changes