Home Care Coordinator

Kintegra Health•Charlotte, NC

11d

About The Position

The Home Care Coordinator develops and implements home care services for Senior Total Life Care (TLC) participants in a home- and community-based model of care. The role coordinates home care and durable medical equipment (DME), assesses the needs of frail elderly participants, and develops care plans. The position works under the direct supervision of the Center Manager and indirect supervision of the Chief Operating Officer. The coordinator supports participants and the interdisciplinary team (IDT) through ongoing assessments, care coordination, discharge planning, and communication with clinical staff and community resources. The role requires current, valid North Carolina driver’s licensure and a vehicle. Before working independently, the coordinator must meet standardized competencies established by Senior TLC and approved by CMS. The position also requires medical clearance for communicable diseases and up-to-date immunizations before direct participant contact.

Requirements

Bachelor’s degree or equivalent experience.
Minimum of one year of experience working with the frail elderly population preferred.
Current, valid North Carolina driver’s license and vehicle.
Ability to work effectively in a team environment.
Excellent communication, interpersonal, and conflict-resolution skills.
Ability to treat geriatric patients and to act only within the scope of authority to practice.
Must meet standardized competencies established by Senior TLC and approved by CMS before working independently.
Must be medically cleared for communicable diseases and have all immunizations up to date before direct participant contact.

Nice To Haves

Experience working with the frail elderly population.

Responsibilities

Assess home care needs of frail elderly participants and identify and develop specific plans of care.
Conduct initial and periodic assessments before scheduled team meetings, at a minimum of every six months, and communicate participant changes to team members.
Coordinate 24-hour care delivery and implementation of home care services, including personal care services, to meet participant needs and ensure quality services.
Reconcile invoices for personal care service hours and home supplies.
Coordinate and authorize all durable medical equipment (DME), and manage home supplies such as incontinence, diabetic, colostomy, and nutritional supplies, as well as services such as Life Alerts and electronic medication reminder systems.
Coordinate DME for participants in nursing facilities according to program standards, interact with facility staff, and assist with discharge planning and arranging appropriate care as approved by the IDT.
Support and collaborate with the interdisciplinary team, promoting teamwork and unity in interactions with team members, coworkers, and participants.
Work efficiently with the IDT when evaluating potential enrollees.
Participate in participant care planning, implement SMART goals and interventions, enter care plan information in a timely manner, and update care plans throughout the reassessment period.
Attend staff meetings.
Work closely with the clinic RN and PCP regarding in-home nursing needs.
Perform acute in-home visits as requested by the primary care provider and/or supervisor.
Work with the Social Worker to provide community resources for participant needs.
Support Senior TLC’s mission, vision, and values.
Perform other duties as assigned.