Current job opportunities are posted here as they become available.
QUALIFICATIONS:
- Minimum of two years’ experience working with homeless and/or low and mixed-income populations, as well as substance abuse, and severe mental health issues.
- Bachelor’s Degree in Health Care or related field preferred.
- Knowledge of community and housing resources and government benefits/welfare system.
- The individual in this position must have good verbal and written communication skills as well as the ability to make sound clinical judgments regarding client care.
- Must be a licensed driver with an automobile that is insured and is in good working order, in accordance with state and/or organizational requirements.
- Possesses current CPR certification.
- Current and satisfactory report on pre-employment physical examination including TB Screening Test or chest X-ray as required by Agency policies and procedures. Must be free from signs of infection and illness.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.
- Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the Member and non-duplication of services.
- Serves as the primary contact to members enrolled in the ECM Program and advocates for members to help them navigate the healthcare while managing their healthcare.
- Conducts comprehensive risk assessments and care planning in collaboration with the members to develop a Patient-Centered Care Plan.
- Complete a bio-psycho-social assessment and a Care Plan for each member on their caseload.
- Oversees the implementation of the client’s Care Plan.
- Develop effective and professional relationships with property owners/managers, housing providers, service providers, care providers, or any relevant providers/partners in the clients continued care.
- Develop effective, trusting relationships with clients with a focus on facilitating their independence and long-term housing stability.
- Facilitate linkage to community resources, mental health, substance abuse and medical services and provide transportation when needed.
- Communicate with mental health, substance abuse and medical providers to ensure continuity of care for the client/member.
- Connect members to other social services and support the member with other needs they may have, including transportation.
- Advocate on behalf of Members with health care professionals, including accompaniment to doctor visits.
- Use motivational interviewing, trauma- informed care, and harm-reduction approaches.
- Coordinate with hospital staff on discharge plan.
- Accompany member to office visits, as needed and according to Managed Care Plan (MCP) guidelines.
- Help clients maintain compliance with treatment plans given to them by medical professionals, this may include medication reminders, service linkages, ordering daily living essentials, and connecting client with DME providers.
- Monitors service delivery, adhering to the prescribed schedule of client contact.
- Conducts face to face visit with Members twice a month or as requested/needed.
- Maintains proper charting, progress notes and case records for each enrolled member in the company EMR system.
- Track interventions and outcomes.
- Handles complaints from clients, families or friends.
- Driving may be required to geographical areas that are covered by the company.
- Reports all signs of abuse or neglect.
- Participates in Education, Training and Quality Improvement Activities.
- Assists the Agency in maintaining compliance with Federal, State, Local and HIPAA Regulations or Joint Commission Standards.
- Establishes and maintains good relationships with all Health Plans and other vendors.
- Performs other duties as assigned.
PHYSICAL REQUIREMENTS:
- Stand, sit, talk, hear, and use of hands and fingers to operate computer, telephone, and keyboard on a frequent basis up to 20% of the time.
- Reach, stoop, kneel and bend up to 15% of the time
- Moderate amount of walking up to 15% of the time.
- Moderate amount of driving up to 50%of the time.
- Close vision requirements due to computer work on a frequent basis
- Light to moderate lifting may be required up to 25lbs on a frequent basis.