Care Coordinator

This posting will remain open until filled with first review of applicants January 14th.

Position provides care coordination services to individuals.  This includes the provision of case management, evaluating and assessing the success of services provided, recommending other services that may be useful, and related work as apparent or assigned.  Position is responsible for using a holistic approach to complete individualized assessments and develop and implement plans to enhance and protect the quality and dignity of life for the diverse population served.

Basic Performance Expectations of all Todd County Staff

• Serves as a positive example to other County personnel with regard to workplace actions, decisions, work skills, attitude and adherence to workplace policy and procedures.
• Has strong communication and interpersonal skills, is honest, fair and dependable.
• Embodies teamwork and cooperation within and across County departments and with the public.
• Communicates effectively with the Department Head and keeps supervisor apprised of important matters ongoing in the department.
• Respect all colleagues, co-workers, board members and the public and lead those around you to do the same.
• This position requires regular and timely attendance in accordance with the department schedule.
• Performs other duties as assigned or apparent.

The following duties are normal for this position. These duties are not to be construed as exclusive or all-inclusive.  Other duties may be required as assigned. To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions.

• Assess clients in the home, other place of residence, office, or community facilities.
• Develop, implement, and evaluate care coordination plans; authorize services for delivery by others involved with a client, define initial and ongoing measurable goals and objectives for individuals.
• Provide care coordination, coordinate and encourage direct services and advocate for clients and families.
• Coordinate the determination of eligibility and level of services needed for identified clients.
• Provide education to families about activities that promote a higher level of wellness and reduce the risk of disease and injury, including environmental health threats.
• Coordinate internal and external client referrals; gathers documentation to assist clients in obtaining services and accessing community resources.
• Communicate with providers and coordinate for the provision of services as indicated by the client's individualized plan.
• Document and maintain client records as required by department policy, state and federal regulations.
• Complete MnCHOICES Assessments.
• Participate in care conferences.
• Interpret department or county policies or other agencies' standards or requirements and coordinate services with others to achieve effective and efficient services.
• Participate in case appeals when necessary, including preparing documentation and providing testimony for legal proceedings when needed.
• Participate in community events as requested, such as health fairs, forums, and groups which may occur weekends or evenings.
• Strictly observes all data privacy laws.
• Complete agency, state and federally required documentation related to client activity, according to identified timelines.
• Provide health plan contracted services follow up for individuals.
• Participate in community assessment and planning as requested.
• Participate in quality improvement and department strategic planning.
• Community resource, information and referrals.
• Others duties as department may implement.

The following is a list of services that shall be assigned depending on the incumbent’s credentials or licensure and agency needs, with consideration given to employee strengths. 

• Long Term Support Services, MnCHOICES & Relocation Services Assessment
• Provide service coordination for a variety of healthcare programs, including MN Senior Health Options (MSHO), MN Senior Care Plus (MSC), Special Needs Basic Care (SNBC), Elderly Waiver (EW), Alternative Care program (AC), Essential Community Supports (ECS) and Community First Services and Supports (CFSS).
• Provides service coordination for Community Alternatives for Disabled Individuals (CADI), Community Alternative Care (CAC), Brain Injuries (BI) waivers.
• Participate in public health emergency preparedness activities, as appropriate or allowed based upon degree and licensure.
• Duties that may be assigned to incumbents holding a valid Nursing license include:
  1. Public Health Nursing Clinic services.
  2. Provision of nursing procedures supportive to physical health such as medication management, injections, use of physical health monitoring devices and medical screening such as pulse oximeter, and blood pressure reading.

• Completion of an approved Associate or Diploma degree that results in MN Registered Nurse Licensure.
• Unencumbered MN Registered Nurse License.
• OR
• Bachelor’s degree from an accredited four-year college or university with a major in social work, psychology, sociology or related field
• Must possess and maintain a valid driver’s license.
• Must pass criminal background check.

Preferred Qualifications

• One-year experience in Social Work or Nursing field.
• Bilingual (English/Spanish)

• Comprehensive skill in coordinating services for clients and evaluating where services may be lacking.
• Comprehensive skill in creating and maintaining client records and service plans.
• Ability to establish and maintain effective working relationships with clients, service providers, staff, managed care organizations, agency representatives, medical facilities, financial agencies and the general public.
• Ability to identify social problems and needs to assess the ability of individuals and families to utilize services in problem solving
• Knowledge of behavior as it relates to individuals, family dynamics and systems, physical and mental illness, chemical dependence, developmental disabilities, traumatic brain injuries, severe emotional disturbances, and aging, in order to maintain optimal health.
• Knowledge of the socioeconomic factors which promote and maintain optimal health for individuals, families and communities.
• Knowledge and utilization of appropriate community resources and services.
• Ability to make independent decision.
• Ability to analyze and evaluate complex and crisis situations and assist individuals and families in resolving those situations.
• Ability to effectively communicate verbally and in writing, including diverse populations.
• Ability to apply motivational interviewing techniques.

• Knowledge of agency operations, policies and procedures.
• Knowledge of quality assurance and quality improvement.
• Skills with computer use and software programs.

• Ability to deal with people who have various cognitive, socio-economic and risk levels.
• Ability to deal with angry, hostile and sometimes unkempt persons in a calm and effective manner.
• Ability to solve problems within scope of responsibility.
• Ability to understand and interpret laws, policies and regulations.
• Ability to prepare reports and maintain records.

• Ability to represent Todd County professionally with other community partners and governmental agencies.
• Ability to work cooperatively and respectfully in all situations.

This work requires the occasional exertion of up to 50 pounds of force; work regularly requires speaking or hearing and using hands to finger, handle or feel, frequently requires walking and sitting and occasionally requires standing, climbing or balancing, stooping, kneeling, crouching or crawling, reaching with hands and arms, pushing or pulling, lifting and repetitive motions; work has standard vision requirements; vocal communication is required for expressing or exchanging ideas by means of the spoken word and conveying detailed or important instructions to others accurately, loudly or quickly; hearing is required to perceive information at normal spoken word levels and to receive detailed information through oral communications and/or to make fine distinctions in sound; work requires preparing and analyzing written or computer data, operating machines, operating motor vehicles or equipment and observing general surroundings and activities; work frequently requires exposure to outdoor weather conditions and occasionally requires wet, humid conditions (non-weather), exposure to fumes or airborne particles and exposure to blood borne pathogens and may be required to wear specialized personal protective equipment; work is generally in a moderately noisy location (e.g. business office, light traffic).

Salary : $28 - $36