Coord, Social Work - FlexStaff

Job DescriptionCARE MANAGER-SOCIAL WORK (REMOTE)Responsible for overall care management and quality of care for participants. Uses specialized discipline-specific knowledge to review assessments of field staff and coordinate a holistic care plan that addresses all domains of care.Job Title: Care Manager - Social WorkJOB PURPOSE:Responsible for overall care management and quality of care for participants.Uses specialized discipline-specific knowledge to review assessments of fieldstaff and coordinate a holistic care plan that addresses all domains of care.Provides care coordination in a manner that is sensitive to age, gender, sexualorientation, cultural, linguistic, racial, ethnic, religious backgrounds, andcongenital or acquired disabilities.JOB RESPONSIBILITIES:- Participates and represents the individual's discipline in the care planningmeetings or as necessary.- The Care Manager will review all discipline-specific documentation forquality and addresses any deficiencies with the field staff followingdisciplinary steps established by the Discipline Policy.- Monitor how field staff is documenting all interventions with theparticipants and address/document any issue observed with theemployee.- Conduct coaching sessions with field staff as needed.- The Care Manager (CM) communicates with the discipline-specific fieldstaff regularly to coordinate a continuum of care consistent with theMember's health care needs and goals. This care plan supports theMember in attaining and maintaining an optimal functional and healthstatus.JOB DESCRIPTIONprovisions of appropriate services to meet identified member-specificneeds (such as assistance with the Activities of Daily Living (ADLs) andInstrumental Activities of Daily Living (IADLs), housing, home-deliveredmeals, and transportation) and when approved by the IDT, may authorizea range and number of community-based services.- Implements specific care management activities and interventions thatlead to accomplishing the participant's goals.- Provides care management services across sites and collaborates withappropriate team members, facility, discharge planner, and home carecoordinator when members are transitioned between care settings.- Documents services in accordance with CenterLight standards andfederal/state regulations- Coordinates, facilitates, and arranges for long-term care services innursing homes, rehab facilities, etc. as needed.- Collaborates with PCP and other Specialty physicians and specialtybasedservices and members of IDT regarding any changes inparticipant's condition to secure, arrange and coordinate all resources forimplementing optimal care.- Provides or arranges for ongoing Skilled services, service authorization,and periodic assessment reassessment and evaluation of services.- Monitors care management activities, services, and members' responsesto interventions, to determine the effectiveness of the plan of care andthe utilization of services and implements changes and adjustments tomeet needs and resolve goals.- Evaluates the effectiveness of the plan of care in reaching desired goalsand outcomes, makes modifications or changes in the plan of care basedon changes in the member's health, as needed.- Fiscally responsible for providing services based on members' needs.- Maintains up-to-date knowledge about current health-related issues,procedures, evidence-based clinical practice guidelines, medications,and impacting health and practice standards.- Conduct competencies, and training sessions with field staff as needed.- Recommends and contributes to improvements in services, programs,policies, and procedures to ensure optimum care and services tomembers.- Follows the organization's policies regarding disciplinary action. EngagesHuman Resources as needed for guidance on disciplinary actions andterminations.- Only act within the scope of the individual's authority to practice.- Meet a standardized set of competencies for the specific positiondescription established by the PACE organization before workingindependently.- Acting member of the IDT.- All other duties as assigned.QUALIFICATIONS:Education: Graduated from a Master Social Work program acceptable to NewYork State Education Department (NYSED.)Experience:- Minimum of two (2) years of administrative experience in a managementcapacity in a certified home health agency (CHHA), Manage Care, longtermhome health care (LHCSA), acute care, medical-surgical, and/orcritical care, nursing home experience, diagnostic & treatment clinicpreferred.- Customer Service experience required.- Managed long-term care insurance experience beneficial.- Minimum of one (1) year of experience working with a frail or elderlypopulation or, if the individual has less than one (1) year of experience butmeets all other requirements, must receive appropriate training from thePACE organization on working with a frail or elderly population uponhiring.- Supervisory experience preferred.Additional Requirements:- Be legally authorized (for example, currently licensed, registered, orcertified if applicable) to practice in the State in which the healthcareprofessional will perform the function.- Be medically cleared for communicable diseases and have allimmunizations up-to-date before engaging in direct participant contact.License: Current active and unrestricted license and registration in New YorkState required.Language: Bilingual, preferred.*Additional Salary Detail