Care Coordinator

The Care Coordinator develops and manages consumer plans of care and provides support functions for an assigned caseload of consumers and Personal Care Assistants (PCAs) to ensure delivery of high-quality home care services in accordance with service authorizations and regulatory guidelines.

Primary Responsibilities:

• Maintains assigned caseload of consumers and Personal Care Attendants (PCAs).
• Conducts in-home and telephonic assessments and wellness calls for assigned consumer caseload to identify individual consumer care needs.
• Reviews and updates plans of care every 90 days, or as needed, to adequately address changes in consumer care needs.
• Conducts wellness call and/or assessment for any triggered event within at least 14 days of the occurrence.
• Completes required documentation for assessments and wellness calls; enters documentation into the consumers record located in the HHA Exchange system within 48 hours and completes any related records or files.
• Reviews PCA Electronic Visit Verification (EVV) entries to verify accuracy of time entries and completeness of plan of care (POC) entries.
• Contacts PCAs to clarify and/or obtain any missing EVV documentation.
• Contacts consumers to confirm accuracy of PCA visit time and care provided when discrepancies or incomplete entries occur.
• Completes timely entry of EVV data and communication documentation in the HHA system.
• Runs exception reports in HHA system to track compliance with EVV regulations and reports findings to Manager.
• Performance review is based on metric performance
• Provides EVV system education/training for PCAs as needed.
• Communicates with PCA at least weekly regarding over/under utilization of service hours; documents findings and notifies manager of same.
• Adjusts PCA schedules as needed due to under/over utilization of service hours to maintain authorized service hours.
• Receives consumer/PCA service schedule changes, supports coverage change process and communicates changes to consumers/PCAs.
• Notifies Authorization Department in the event that documented authorization does not cover scheduled services.
• Addresses and resolves consumer and PCA concerns and appropriately escalates issues to manager and/or appropriate person/department.
• Provides excellent consumer customer service and consumer advocacy.
• Provides timely communication to the consumers external Service Coordinator directly or via the HHA system regarding changes in consumer status or pertinent home/community safety issues.
• Reports suspicion or any acts of physical abuse, verbal abuse, or mental abuse to Adult Protective Services (APS).
• Notifies the PA Department of Human Services (DHS) - Bureau of Program Integrity regarding any reports of consumer exploitation via email or the PA DHS reporting system.
• Creates and submits PA DHS Enterprise Incident Management (EIM) reports via the PA Department of Public Welfare (DPW) portal as per regulatory requirements; notifies manager that EIM report was submitted.
• Responds to department phone calls to provide prompt, quality customer service to internal and external customers.
• Completes required initial training modules and annual training as per agency policy.
• Assists in onboarding of new Care Coordinators to the team as assigned by the Manager.
• Attends team meetings and one-on-one meetings with Manager to review caseload, provide consumer updates, and review work performance according to defined department metrics.

Perform other specific tasks related to the department as assigned.

Will Demonstrate the following Skills:

• Basic understanding of medical conditions and terminology.
• Experience working with a client diverse population.
• Effective case management skills with excellent judgment and ability to identify consumer needs.
• Strong customer service skills.
• Excellent organizational skills.
• Strong verbal and written communication skills.
• Ability to accurately document information pertaining to consumer services in a timely manner.
• Ability to manage assigned responsibilities in a business professional manner.
• Ability to assess individual consumer needs and care requirements and develop/update a plan of care to enable assigned caregivers to safely address identified needs.
• Effective problem-solving skills to determine the source of a problem and identify an effective solution.
• Excellent interpersonal skills including empathy, compassion and effective listening skills.
• Self-sufficient with ability to complete tasks in an autonomous manner.

Meet prescribed deadlines and respond promptly to urgent issues.

• Excellent computer skills in a Microsoft Windows environment and ability to effectively utilize the HHA Exchange system.
• Reliable with timely completion of tasks and meets deadlines.

Education/Experience Requirements

• A minimum of an Associates degree in related field required.
• At least 5 years of experience in a health care or home care environment preferred.
• Valid drivers license.
• Daily access to a reliable, registered and insured vehicle.

  Physical Demands & Environment

  Working in normal office environment, employee may be required to sit, bend, stoop, use keyboard, see, talk, and hear. May occasionally lift objects of 10 to 25 lbs. Field work including but not limited to entering consumer homes required. In compliance with applicable law, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.