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AFC Care Manager

LifeStream•Fall River, MA

About The Position

The AFC Care Manager coordinates and supports Adult Foster Care (AFC) services for members and caregivers. The role includes conducting required on-site visits, coordinating referrals and assessments, reviewing member information, evaluating psychosocial status and placement appropriateness, and collaborating with members, caregivers, clinical staff, and other members of the multidisciplinary team to develop and monitor person-centered Plans of Care. The position requires a bachelor’s degree in a relevant field, experience working with older adults or individuals with disabilities, and the ability to work independently while managing multiple cases. The schedule is Monday through Friday, 8 a.m. to 4 p.m. Starting salary is $55,000. A resume must be attached to the application for consideration.

Requirements

  • Bachelor’s degree in Social Work, Human Services, Nursing, or a related field.
  • Experience working with older adults or individuals with disabilities.
  • Knowledge of care coordination and community-based services.
  • Strong communication, organizational, and interpersonal skills.
  • Ability to work independently and manage multiple cases.
  • Maintain an acceptable CORI.
  • Pass a negative drug screening.
  • Valid driver’s license.
  • Use of a personal vehicle for work purposes.

Responsibilities

  • Conduct required on-site visits with each AFC member and caregiver at the qualified setting, in accordance with the member’s AFC service level and applicable MassHealth regulations.
  • Coordinate AFC referrals, intake activities, and preadmission assessments with the AFC Registered Nurse and Director of Community and Family Services.
  • Coordinate with MassHealth or its designated Public Assessor Option, when applicable, to obtain initial clinical assessment results and required authorization documentation.
  • Obtain and review available medical, social, and psychosocial information to support appropriate AFC admission and ongoing service delivery.
  • Obtain a comprehensive social history and conduct psychosocial evaluations of AFC members in accordance with MassHealth requirements.
  • Conduct initial and ongoing evaluations of members’ psychosocial status and the appropriateness of AFC placement.
  • Participate in developing, implementing, and reviewing each member’s AFC Plan of Care with the member or responsible party, AFC Registered Nurse, caregiver, and other designated multidisciplinary team members.
  • Ensure each Plan of Care reflects the member’s strengths, preferences, identified needs, goals, desired outcomes, and available community resources.
  • Assist in developing measurable, person-centered goals and interventions addressing members’ medical, social, emotional, and functional needs.
  • Monitor implementation of the Plan of Care and identify concerns or changes requiring follow-up or multidisciplinary review.

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