Reablement Coordinator

NTUC HEALTH CO-OPERATIVE LTD; Singapore; On-site; SGD 52,000 - 78,000; Full time

Job summary

NTUC Health Co-Operative Ltd is seeking a Reablement Coordinator to manage referrals, coordinate programme delivery across services, and monitor participant progress throughout the reablement cycle. You will also provide caregiver training and ensure smooth transitions between care services.

Responsibilities include screening referrals with an OT, conducting InterRAI assessments, data tracking, and supporting documentation. Location is Kampung Admiralty, Boon Lay, Singapore.

Responsibilities

• Screen and triage referrals with OT to determine needs.
• Conduct functional screening and InterRAI assessments.
• Monitor progress, track milestones and recruitment numbers.
• Coordinate referrals and programme delivery across services for smooth transitions.
• Deliver community integration interventions as prescribed by OT.
• Support caregiver training and reinforce progress with families.
• Facilitate transitions to next care service for continuity of care.
• Where needed, conduct home visits with OT or for follow ups.
• Coordinate meetings with staff and caregivers to review cases.
• Organise case discussions between client, caregiver and care team.
• Review intervention progress for clients in existing services.
• Maintain programme documentation and schedule MDT meetings.
• Maintain accurate data tracking for monitoring and reporting.
• Support data collection such as satisfaction surveys and process evaluations.
• Perform other duties as assigned by OT and reporting officer.

Job description

The Reablement Coordinator manages referrals, coordinates programme delivery across services, supports and monitors participant progress throughout the reablement cycle, including caregiver training. This role aims to sustain long term independence and prevention of hospital admission of seniors. He/she will also provide operational and administrative support, including scheduling, documentation, InterRAI assessments, and data tracking for programme monitoring and reporting.

Key Responsibilities:

1) Programme delivery

• Work closely with occupational therapist (OT) to screen and triage referrals from various referral sources.

• Conduct functional screening, assessment and outcome measures, including InterRAI

• Monitor programme progress, recruitment numbers, and track milestones against the proposed timeline.

• Manage participant referrals and coordinate programme delivery across services, including working with service staff to ensure seamless care transitions.

• Deliver community integration interventions relating to the goals of the participants as prescribed by the OT

• Monitor participant progress throughout the reablement cycle and support caregiver training and reinforcement.

• Support transition to the next care service to ensure a warm handshake and smooth transition.

• Where required conduct home visits with OT or independently for follow ups.

2) Care coordination

• Coordinate meetings with service staff and other stakeholders including caregivers

• Organise case discussion and conference between client, caregiver and care team

• Conduct regular review of intervention and progress of clients in existing services.

3) Data collection, Reporting and administrative duties

• Manage programme documentation, including scheduling and coordination of case discussion and multidisciplinary meetings with other stakeholders, including clients and caregivers.

• Maintain accurate data tracking for programme monitoring, evaluation and reporting.

• Support other data collection such as post programme satisfaction survey, process survey to evaluate programme effectiveness.

• Any other duties as assigned by occupational therapist and reporting officer.

Key Deliverables:

• Timely completion of screening and assessments
• Maintain 100% compliance in documentation and outcome tracking through the reablement cycle.
• Ensure all clinical matters, risk incidents are escalated and reported promptly to OT/Service staff.

Locations:

• Kampung Admiralty, Boon Lay