PACE Home Care Coordinator - East Region (Must have CNA & HHA)

San Ysidro Health•El Cajon, CA

15d•$27 - $34

About The Position

The PACE Home Care Coordinator HHA is a collaborative member of the interdisciplinary team (IDT) and provides foundational support to the Home Care Coordination team under the supervision of the San Diego PACE Home Care Coordination RN Manager. The coordinator conducts home safety evaluations and coordinates and monitors IDT-approved services, including meal delivery, caregiver services, durable medical equipment, and incontinence supplies. The role advocates for participants’ healthcare needs and preferences and helps ensure that unskilled home-based care is coordinated in a person-centered and compassionate manner. The coordinator works with participants, families, healthcare providers, caregiver agencies, DME suppliers, and IDT members to coordinate schedules, monitor service delivery and quality, identify service gaps, and recommend care-plan adjustments. The position documents services and actions in logs and participant electronic medical records, supports SD PACE nurses, conducts home visits, and delivers supplies or equipment as needed. The job involves frequent travel to participant homes and SYH and San Diego PACE sites.

Requirements

At least one year of experience with the frail or elderly population.
CNA (Certified Nursing Assistant) and HHA (Home Health Aide) certifications.
Valid California driver's license and vehicle insurance.
CPR and First Aid (BLS) certification from the American Heart Association.
Effective oral and written communication skills and ability to follow written and oral instructions.
Attention to detail when typing and proofreading materials.
Ability to communicate effectively and work collaboratively.
Basic computer skills, including Microsoft Suite, Outlook, and Excel.
Highly organized and responsive, takes initiative, and can collaborate as a team member while independently executing tasks.
Skills necessary to coordinate and evaluate services for geriatric participants.
Firm understanding of the Home Health Aide scope of practice and ability to work only within that scope.
Professional and personable demeanor to maintain excellent working relationships.
Strong organizational skills and excellent attention to detail.
Ability to solve problems and identify opportunities and potential challenges.
Ability to maintain confidentiality and discretion and deal effectively and tactfully with staff, patients, and the public.
Must complete pre-employment I-9, physical, positive background and reference checks, application, new-hire orientation, and pre-employment PPDs.
Must comply with all mandated vaccinations and boosters as a condition of employment.

Responsibilities

Coordinate IDT-approved meal delivery to participants’ homes.
Coordinate IDT-approved durable medical equipment and incontinence supply delivery to participants’ homes.
Coordinate IDT-approved caregiver services for participants.
Complete the Home Care Coordination care plan at enrollment and semi-annually thereafter as an IDT member.
Conduct pre-enrollment, annual, semi-annual, and change-of-address home safety evaluations.
Document and track actions, services, and service-delivery status in designated logs and participant electronic medical records in accordance with clinical, DHCS, and CMS regulations and guidelines.
Review progress notes and service-delivery documentation and inform the IDT of service gaps for reconciliation.
Upload progress notes, reports, and care- or vendor-related documentation to the EMR.
Communicate regularly with participants, their families, and other healthcare providers to coordinate care delivery.
Advocate for participants’ healthcare needs and preferences and support person-centered, compassionate care.
Support SD PACE nurses in coordinating and delivering meals, DME, caregiver services, and related services.
Collaborate with physicians, social workers, therapists, and other interdisciplinary team members to coordinate participant care.
Adhere to infectious disease precautions to prevent the spread of organisms.
Attend center staff meetings and in-service educational training programs.
Assist Home Care Coordination RNs as requested.
Conduct and document monthly visits for homebound and RCFE participants.
Conduct home visits as needed.
Assist participants with surveys.
Deliver supplies, equipment, grocery bags, and other requested or needed items.
Generate and maintain reports on services provided to participants.
Communicate and work effectively with participants and coworkers.
Participate in interdisciplinary team meetings as needed.
Follow SYHC and PACE attendance and punctuality policies and established PACE, ADHC, departmental, and position-specific policies and procedures.
Attend required meetings and participate in committees as directed.
Maintain health and safety standards, participate actively in the Safety and Injury Prevention in the Workplace Program, and maintain required records and documentation.
Perform other related duties as assigned or requested.