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DEPARTMENT: Home Care
POSITION: Care Manager
SUPERVISOR: Care Management Assistant Director, or Home Care Program Manager
STATUS: Full-Time, 35 hours per week, non-exempt
SALARY: $38,182 or more based on experience

MAJOR RESPONSIBILITIES: Interview and assess applicants for community based services. Develop and initiate service plan.  Coordinate consumer services, reassess periodically and provide short-term crisis management support to consumers while performing responsibilities as part of a Home Care team.

DUTIES:

  1. Maintain an ongoing caseload of consumers:
    1. Coordinate services with provider(s) and informal/formal supports. Participate in care conferences as necessary.
    2. Conduct home visit. Reassess each consumer’s need for service at least every 6 months by a personal interview in the home. The full CDS is completed twice each year.  Consumers on a more frequent visit schedule have the additional visits documented as a narrative in the SAMS Journal.  Finanical Redetermination is conducted annually.
    3. Update activities and referrals in SIMS to facilitate scheduling of tasks.
    4. Provide short-term support and intervention to consumers and their families during a potential crisis.
    5. Collaborate with Protective Services Program to address potential risks to consumers.
    6. Make referrals to, and conduct joint consultation visits with, appropriate services as necessary. Consult with Interdisciplinary partners as needed in the interest of care coordination.
    7. Act as an advocate for consumers in areas such as Social Security, Medicare, SSI, Medicaid, housing, legal services, fuel assistance, SNAP, etc. Determine whether community resources might be utilized to improve the consumer’s situation.  Assist consumer in coordination of these services as necessary.
    8. Assist consumer with appeals process.
    9. Monitor all cases on an ongoing basis and follow up on identified issues.
    10. Conduct initial assessment of needs via personal interview within the applicant’s home, or at the hospital before discharge as required.
    11. Develop a care plan based on assessment, consultation with intake team, and recommendations of other professionals and family members involved with consumer. Advocate for changes in program assignment or services as necessary.
    12. Follow protocols as assigned, such as mini-cog, risk assessment, falls prevention, etc., in order to meet EOEA requirements.
  2. Maintain current information relating to each case:
    1. Maintain current information relating to each case:
    2. Keep files up to date: include in Journal a summary of telephone calls, changes in purchased services schedule, observations by homemaker, or other professionals regarding the consumer, as well as observations made during the home visits.
    3. Maintain all forms in compliance with the State Home Care Regulations.C. Complete care plans and service plans, suspensions, terminations and other changes in the SAMS service plan for providers and for the Fiscal Dept.
    4. Record and maintain statistical data. Complete weekly, monthly and annual reports.  Evaluate providers utilizing designated forms.
    5. Maintain appeals forms, notifying consumer of any changes in care plan. Retain copies of any correspondence pertaining to case.
    6. Achieve an acceptable level of proficiency in computer programs required by EOEA for consumer reporting (e.g. SAMS).  Update skills as computer programs are revised.
  3. Participate in teams and department:
    1. Participate with team and department in problem-solving.
    2. Participate in departmental initiatives and projects.
    3. Provide coverage as assigned by the duty roster system.
    4. Collaborate with Case Manager Assistants for effective handling of workload.
  4. Participate in staff development programs.
    1. Update knowledge pertaining to elderly populations and services by means of courses and in‑service lectures, workshops, etc.
    2. Attend and contribute to regular Agency staff meetings and Home Care meetings.
    3. Perform other duties as assigned.

QUALIFICATIONS:

  1. Bachelor’s degree in human services, social work, nursing or related field. Exception is made for those with needed linguistic capabilities who also have a bachelor’s degree in another area and 5 years directly related work experience. 
  2. Experience working with the elderly and/or experience working in a community service setting is preferred.
  3. Ability to utilize interpersonal skills in relating sensitively to the concerns affecting the elderly individual and their population as a whole.
  4. Ability to observe and report objectively in both a verbal and written manner.
  5. Previous experience working in a team-based environment highly desirable.
  6. Flexibility to accept changing priorities.
  7. Excellent communication skills.
  8. Must be able to drive or travel in an efficient manner.
  9. Must be able to traverse at least two flights of stairs.
  10. Familiarity with computer and basic word processing skills

*          If applicable, designates non‑essential position function as required by the ADA.