Case Management – Accept client referrals from and carry out Case Management responsibilities under the direction of the Case Management Coordinator.

·         Accept referral and complete an intake per program guidelines.

·         Complete a comprehensive assessment.

·         Develop a service plan

·         Implement services and provide ongoing monitoring

·         Conduct at least one (1) Home Meds assessments per month

·         Conduct Medicare Screen and applicable applications on all Medicare eligible clients requesting Material aid assistance

·         Follow-up and reassessment of the client:

·         Monthly client/collateral contact via telephone or in-person

·         Annual face-to-face reassessment unless needed sooner due to client status change

·         Client discharge/transfer

·         Records and documentation in WellSky database to include:

o   Intake form

o   Comprehensive Assessment

o   Mental Status Questionnaire

o   Personal Health & Safety Plan

o   Releases of Information

o   Service Plan including signature page

o   Record of referrals and requests

o   Correspondence related to the case

o   Case Notes documented in WellSky Journals and Activity & Referrals

o   Enter Service Deliverables in WellSky for billable and non-billable activity

Options Counseling –

·         Population includes 18-59 year olds with disabilities, Caregivers, individuals age 60+

·         Utilize person-directed approach with the consumer to engage and discuss their goals.

·         Assess needs, values, and preferences in order to discuss options.  

·         Explain pros and cons of various options and support persons to facilitate decision making.

·         Develop person-directed action plan to support their decisions.

·         Identify existing consumer resources and supports.

·         Advocate for consumer decisions about services and supports.

·         Identify available resources to address unmet needs.

·         Make referrals or facilitate access to services, including assistance in completing applications or making phone calls.

·         Enter all client interactions into the WellSky Database on a daily basis and maintain all client documentation. 

·         Provide follow up to determine how well the action plan is working or if it needs to be revised. 

·         Conduct at least one (1) Home Meds assessments per month

·         Conduct Medicare Screen and other applications on Medicare eligible clients requesting Material aid assistance

·         Make presentations to consumers, service-providers, and other community groups as requested and approved by your supervisor.

·         Attend staff meetings and training events.

·         Performs other duties as assigned.  

·         Elsevier and AIRS Training requirement

REQUIRED QUALIFICATIONS:

·         Bachelor’s degree in a human services field (preferred one year of experience to meet AIRS Certification); OR

·         Associate’s degree and two years of experience working in the areas of aging, disabilities, community health or hospital discharge planning; 

·         Must become trained and/or certified as an Alliance of Information and Referral Specialists (AIRS) within 12 months and Adult/Child Mandatory Reporter within 6 months of employment.  

·         Must successfully complete the Person-Centered Counseling curriculum provided by Elsevier within 30 days of employment as an options counselor; OR if already CADER certified must complete the Person-Centered Thinking course provided by Elsevier

 PHYSICAL DEMANDS:

The person occupying this position must be able to perform all responsibilities and tasks outlined above, which may include:

1.       Lifting items weighing up to 30 pounds along with bending and twisting simultaneously, including lifting program materials and supplies onto/off of cart and laptop and other media equipment;

2.       Standing for extended periods of time – up to one hour;

3.       Sitting for extended periods of time.

Employee in this position must have reliable transportation to and from work.

While performing the duties of this position, the employee is occasionally required to walk, sit, use hands or fingers, feel objects, tools, or controls, reach with hands and arms, talk and hear.

Reasonable accommodations may be made to enable individuals with disabilities to perform the duties that are not essential for satisfactory performance of the position.

WORK ENVIRONMENT:

Noise level in the work environment is moderate.

Elderbridge and its employees strive to provide a respectful work environment where all individuals are treated with respect and dignity and are inspired to use their creativity to meet consumer needs. All relationships among persons in the workplace are to be business-like and free of bias, prejudice and harassment.