Social Work Case Manager

INNOVATIVE INTEGRATED HEALTH•Fresno, CA

1d•Onsite

About The Position

The Social Work Case Manager is responsible for providing direct social work case management services to participants. The goal is to empower senior participants to age at home with dignity through personalized, comprehensive care plans that deliver high-quality health and human services along with strong community support.

Requirements

Interest in the risk-based long-term care program to serve frail elderly in a community-based setting.
Experience and thorough knowledge of social service principles and practices.
Knowledge of psychosocial, behavioral, and family needs of the elderly population.
Knowledge of financing mechanisms such as Medicare, Medicaid, and Prospective Payment Systems.
Knowledge of the local and social service delivery systems and aging network.
Proven ability to work in an interdisciplinary team.
Ability to work effectively and harmoniously with the staff, the elderly, and providers of services, public, and private agencies.
Energetic, dependable, resourceful, and flexible.
Effective oral and written communication skills.
Computer skills required.
Ability to access all areas of the center throughout the workday.
Ability to communicate verbally with an excellent comprehension of the English language.
Bachelor’s degree in social work or related field required.
CPR with First Aid certification.
Is medically cleared for communicable diseases and has all immunizations up-to-date before engaging in direct participant contact.

Nice To Haves

One (1) year of documented experience in working with a frail or elderly population required.
Prefer experience in a community-based setting or geriatric program.

Responsibilities

Follow social work directives from interdisciplinary team (IDT) and meet with family members and other community members/agencies as needed.
Coordinate ongoing family meetings, as needed.
Provide ongoing case management and advocacy as required.
In conjunction with the interdisciplinary team, coordinate discharge planning for participants returning home from hospital or nursing facility.
Maintain current, written case management records, including ongoing documentation of services provided, and participants expressed wishes.
Act as liaison between the participant and other agencies such as Department of Aging, Social Security Administration, Medicaid, etc.
Participate in participant-related meetings with external agencies and conferences in the community as needed.
Assist with ongoing government program financial eligibility applications for participants, including recertification as needed.
Identify housing resources for participants offered by the community/county.
Assist participants with housing resources such as eligibility forms, applications, and navigating various housing options.
Conduct home visits, as needed.
Assist in connecting with hard-to-reach participants.
Maintain confidentiality of participant information.
Attend and participate in staff meetings, in-services, projects, and committees as assigned.
Adhere to and support the center’s practices, procedures, and policies including assigned break times and attendance.
Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
Be flexible in schedule of hours worked.
May require use of personal vehicle.