DESCRIPTION: Reporting to a Supervisor, this position facilitates and coordinates long-term services and supports, utilizing a person-centered approach to improve psychosocial and health outcomes. In accordance with procedures and requirements of Community Health Choices (CHC) Managed Care Organization (MCO), the Service Coordinator has responsibility for ongoing assessment, service planning, service coordination, monitoring, follow-up, and evaluation for persons with disabilities and/or older adults. The SC works within a collaborative team approach to identify and address participants’ needs, preferences, and goals related to physical health, behavioral health, social services, and long-term services and supports. SCs work primarily remotely when not in the field but do have access to the office, as needed. All SCs are provided with a tablet and mobile phone to fulfill work duties.
Qualifications:
Education: Bachelor’s degree in Social Work, Psychology, or related field.
Experience: Minimum of three years employment in a social service or health care related setting.
Professional Characteristics:
· High energy level; able to manage a variety of tasks simultaneously.
· Excellent interpersonal and communication skills.
· Well organized.
· High level of flexibility
· Utilizes critical thinking
· Strong computer skills
· Cultural competency
Duties and Functions:
a. Conducts comprehensive person-centered assessments
b. Works with participant, his/her family, and/or caregiver, to develop an individualized service plan, making use of consultation with other disciplines as indicated.
c. Identifies, mobilizes, and arranges informal and formal resources to meet participants'' needs.
d. Adheres to all documentation and reporting requirements.
e. Conducts home visits and telephone contacts per MCO standards to monitor adequacy and continued appropriateness of service plan as well as goal achievement.
f. Facilitates care transitions
g. Provides coordination with behavioral health services
h. Utilizes tablet in the field. Completes all necessary forms and data entry for participants’ record, other management information, and other written reports as required, such as critical incidents.
