SEARCH CAREER OPPORTUNITIES

·       Serve as a care coordinator for an assigned caseload of nursing facility residents.

·       Conduct monthly in-person or virtual visits with each nursing facility resident and guardians, if applicable with at least one in-person             visit per quarter

·       Review and document all relevant information including written clinical summaries into data system applications in accordance with            program guidelines and regulations.

·       Participate in quarterly nursing care planning meetings with the nursing facility.

·       Act as an advocate for assigned nursing facility residents to ensure their needs are being met.

·       Ensure all recommended PASRR services are delivered to assigned nursing facility residents.

·       Identify service gaps and solutions to gaps through innovative programming

·       Monitor the clinical appropriateness of the residents facility and community-based supports and address issues accordingly

·       Escalate concerns with the residents care to the proper oversight authority(s)

·       Act as an active member of the residents transition planning to community living; if applicable

·       Maintain individual records documenting all applicant/participant encounters and contacts into data system applications in                            accordance with program guidelines and regulations.

·       Support in the preparation and responses to requests for statistics and resource/service data

·       Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals, long             term care facilities and other programs/organizations involved in the provision of services

·       Participate in public relations efforts, attending conferences and meetings as needed

·       Maintain positive working relationships with applicant/participants, and relevant informal supports, provider organizations, program              consultants and state agencies

·       Maintain the confidentiality of all business documents and correspondence per UMass Chan Medical School/ForHealth Consulting              procedures and HIPAA regulations

·       Participate in performance improvement initiatives and demonstrate the use of quality improvement in daily operations

·       Comply with established departmental policies, procedures and objectives

·       Comply with all health, safety and program regulations and requirements

·       Bachelors Degree in social work; a related health and human services field or equivalent.

·       OR

·       A Licensed Practical Nurse (LPN) with an Associates Degree or equivalent.

AND

·       2 years of work experience providing direct service, care coordination, or case management to adults with psychiatric disabilities, inclusive of 1 year of experience in a medical or clinical setting with knowledge of medical terminology.

·       Demonstrated knowledge and experience with relevant social service/rehabilitation systems.

·       Ability to travel statewide with a valid drivers license

·       Proficient in the use of Microsoft Applications, including Word, Outlook and database

·       Experience with disabled or long-term care populations

·       Experience in community mental health and behavioral health services and one of the following areas: Long-Term Care, Home Care, Rehab, and/or Disabilities

·       Ability to understand and utilize resources for problem solving, in order to deal with problems involving multiple variables, effectively prioritizing and executing tasks in a high-pressure environment.