Assisted Living Transitions of Care Manager

Cypress Cove•Fort Myers, FL

1d•Onsite

About The Position

We are seeking an experienced, compassionate, and highly organized Full-Time Assisted Living Transitions of Care Manager to play a vital role in supporting residents across our continuum of care. This is an exciting opportunity for a professional who is passionate about resident advocacy, care coordination, family support, and helping older adults experience successful transitions while receiving exceptional service.

Requirements

Valid and current LCSW, LMSW, or RN Florida License of 5 years of similar experience.

Responsibilities

Complete pre-residency assessments of potential assistant living residents and coordinate evaluations for transitions to a higher level of care. Offers recommendations for appropriate level of residency in conjunction with the Transition and Clinical Teams.
Assess the medical and psychosocial needs of residents and refers to the appropriate service provider as necessary in collaboration with the DON/ADON and nurses.
Make medical appointments for Assisted Living Residents off recommendations of the nursing team.
Complete new resident admission paperwork including contract review and new resident orientation.
Maintains records on all residents served and documents activity as appropriate including but not limited to advanced directives, living wills, DNR, healthcare surrogate, emergency contacts, My Life, etc.
Collaborates effectively with internal departments and all levels of personnel on a wide variety of resident issues.
Oversee the moving process and the liaison with Move-In Coordinator and Renovations Team regarding time-line expectations of transitions to insure a seamless process.
Serves on various committees as required by the Administrator.
Conducts independent follow up assessments of residents after moving in to determine level of adjustment.
Monitors incident dashboard and provides follow up as needed. Identifies residents in need of service, either through direct referral (from families, other residents, staff, etc.), or by the regular review of incident dashboards.
Monitors the needs of residents routinely and maintains a list of those residents at risk of functional decline.
Provides psychosocial support to residents and their families, individually, via family meetings or support groups and assists through the transition process to a higher level of care.
Develops referral network within the greater SWFL community for available services. Makes appropriate referrals to and consults with other professional service providers as required.
Continues to enhance professional skills through continuing education, community in-services, leadership training, and other professional activities. Shares knowledge gained from training and educational sessions.
Formally addresses and documents independent living resident grievances.
Participates in company-sponsored events as needed.