Care Coordinator/Social Worker Job Description

A Step Above Case Management is seeking an experienced and motivated individual to join our agency as a Care Coordinator/Social Worker. Our Care Coordinators are responsible for coordinating the in-home care for our Senior population. Care Coordinator will manage the care through the multiple service providers in Gwinnett/North Fulton/Dekalb counties.

• Monthly Contacts (telephone, email or text)
• Care Plan Reviews (Initial 30 Day in-person visit and every 90 days after)
• Incident Reports (as necessary)
• Assessment Notes
• Managing any change in service requests

Social Service Duties:

• Researches and maintains up-to-date knowledge of community resources.
• Participates in case conferences with the RN/LPN Case Management to discuss the plan of care as needed. Provides information on the availability of services, delivery options, and on the feasibility of implementing the service needs identified by the RN. In cooperation with the RN, determines the cost for implementing the plan of care for the client.
• Serves as the liaison between the assessment process and the effective delivery of direct services.
• Brokers the Traditional/ Enhanced EDWP services and implements the care plan.
• Arranges for non- Traditional/ Enhanced EDWP community-based services needed by the client.
• Notifies RN Case Management of any change in client status. Collaborates with RN re ECM/TCM changes that may influence eligibility.
• Monitors service delivery to individual clients to assure services are being provided as appropriate and effectively meets the client's needs.
• Continuously reviews, monitors, and updates the comprehensive care plan.
• Documents case activity and service information.
• Communicates and coordinates with all agencies providing direct services to the client.
• Approves/denies providers’ requests for increased services based on the care plan and needs of the individual. Limits amount and frequency of service in order to assure that costs do not exceed the limitations established by the Department of Community
• Health and the Department of Medical Assistance.
• Conducts personal contacts with each client monthly, by phone or quarterly site visits, in order to provide effective Case Management. Completes the 30 and 90- day CCP Review
• Performs the monthly contact assessment in consultation with the client/caregiver.
• Develops the 30/90- day comprehensive care plan in consultation with the client, client's family and service providers.
• Reports suspected abuse, neglect, or exploitation of any client to APS if client does not live in a PCH, or to LTCO and ORS if client lives in a PCH. Reports information to the ALS family model provider, if appropriate.
• Arranges emergency services.
• Completes the Service Authorization Form (SAF). De-authorizes unused services timely.
• Monitors the expenditure of funds for Title XIX waivered services in the planning and service area, in cooperation with the lead agency.
• Sends/uploads necessary information to county DFCS office/Gateway System when
• LOC returned and services begin.
• Communicates with DFCS/uploads to Gateway regarding MAO/PMAO eligibility.
• Maintains confidential case records on all Traditional/ Enhanced EDWP clients.
• Requests redetermination of the client's level of care prior to its expiration or if there is a change of status, new services required.
• Advocates for the special needs of the functionally impaired population requiring community based services.
• Maintains knowledge of the provider service standards for each Traditional/ Enhanced EDWP service.
• Assists clients with appeals and attends hearings. Provides data and client records required by hearing officer as required.
• Attends Traditional/ Enhanced EDWP Network meetings and other meetings coordinated by AAA.

Requirements/Qualifications

• Bachelor's degree in social work, sociology, psychology, or a related field, AND/OR two years experience in the human service or health related field.

Preferred Skills

• Ability to effectively coordinate and communicate with clients, service providers,general public, and other staff members
• Skill in establishing and sustaining interpersonal relationships
• Knowledge of human behavior, gerontology
• Skills in team building and group dynamics
• Knowledge of community organization and service system development
• Problem solving skills and techniques
• Knowledge and skill in social and health service intervention techniques and methodology.
• Google Sheets
• Excel
• Word
• Wellsky

Job Type: Contract

Pay: $51,000.00 per year

Schedule:

• Choose your own hours

Work Location: On the road

Salary : $51,000