Care Manager I

Institute on Aging • Salinas, CA

7d

About The Position

The Care Manager I (CMI) provides case management services for Community Living Fund (CLF) clients who are older adults and adults with disabilities, ages 18+. The CMI is responsible for the assessment of clients with multiple medical and psychosocial needs, and also plans for and monitors services and interventions ensuring provision of quality care.

Requirements

• B.A or B.S in Social Work or related field required.
• One year working with disabled adults and/or older adults required.
• Experience with and understanding of the medical and psychosocial problems of functionally impaired adults and older adults.
• Exceptional communication and presentation skills relating to the functionally impaired adults and older adults, their support systems and teams of health professionals.
• Demonstrates case management skills and experience in the community health care delivery system.
• Detail oriented with good problem solving skills and the ability to prioritize multiple tasks.
• Computer literacy required.
• Bilingual English/Spanish required.

Nice To Haves

• Experience working with individuals with mental and/or behavioral health diagnoses and substance abuse disorders highly desired.

Responsibilities

• Conducts comprehensive assessments and on-going re-assessments of the client and including psychosocial, physical and mental health, environmental and spiritual needs.
• Writes comprehensive assessments.
• Based on assessment information with the client develops and initiates the Community Living Plan, which is client-centered, comprehensive and consistent with program guidelines and policies and procedures.
• Conducts home visits, acute hospital & skilled nursing facility visits, as well as escorts clients to medical and other appointments as clinically indicated.
• Identifies arranges for and monitors appropriate community services based a good knowledge of Medicare, Medi-Cal, and other entitlement programs.
• Establishes and maintains a care management relationship with clients and their significant others as appropriate, offering respect, dignity and support.
• Provides crisis intervention, advocacy, problem solving and therapeutic interventions.
• Meets with clients at least monthly, and more often as clinically indicated.
• Reviews and modifies their care plan on an ongoing basis.
• Documents via progress notes all case management activity regarding identified problems within 24-48 hours, adding any new problems to the care plan, as needed.
• Maintains required paperwork and follows a clear, concise, and consistent system of charting to allow for continuity of care.
• Ongoing evaluation for client Purchase of Service needs and follow-up to determine if services have been provided in a timely manner.
• Educates clients and significant others about resources.
• Establishes and maintains open and effective communication with community providers, including physicians and other health care and social service workers.
• Provides appropriate information on all significant aspects of individual client care and program operations, while maintaining necessary confidentiality.
• Monitors the quantity and quality of the services provided by other involved providers.
• Working closely with the team, continuously evaluates the clients’ ability to remain safely at home; coordinates placement as appropriate, according to Community Living Fund guidelines.
• In collaboration with the client, caregiver, and involved services, terminates clients when appropriate.
• Documents the process as required.
• Participates in data collection, as required.
• Participates in and promotes ongoing efforts towards Continuous Quality Improvement.
• Attends and actively participates in team and program meetings, activities and problem-solving endeavors; contributes to open lines of communication within the team.
• Utilizes supervision appropriately, maintaining open lines of communication and providing updates on caseload activity.
• Actively incorporates the ethical and legal standards of the National Association of Social Workers into all aspects of interactions with others.
• Understands and applies the regulatory and procedural requirements of Community Living Fund as well as the policies and procedures of the Institute on Aging.
• Attends continuing education classes and/or in-service training to increase knowledge, skills and attitudes related to case management, gerontology, family and community systems and other areas relevant to the Community Living Fund client population.
• All other reasonably related responsibilities as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level