Job Description

JOB SUMMARY:
Under the general supervision of the Supervisor, Care Coordination, will provide behavioral/physical health assessment and treatment planning, case management, support, education, and consultation. Will communicate and coordinate care in order to keep member living independently in the community. Function as an effective team member and represent the agency in a professional manner.

CERTIFICATION & LICENSURE REQUIREMENTS
Driver's License upon hire.

EXPERIENCE REQUIREMENTS
Bachelor's degree preferred and/or experience.

ADDITIONAL REQUIREMENTS

• Use of usual and customary equipment used to perform essential functions of the position.

SKILLS AND KNOWLEDGE
Ability to delegate wisely, exercise good judgment, maintain good interpersonal relationships, adapt to change, evaluate critically and think creatively.Individual will demonstrate knowledge and skills necessary to provide appropriate care to members/clients.Individual will demonstrate effective written and verbal skills allowing communication with physicians, co-workers, other clinic/hospital personnel, as well as the public.Position requires good organizational skills.


ESSENTIAL FUNCTIONS:

Key Accountability

• Provides care coordination services primarily in the member/client's home.
• Provides assertive community outreach and sustained efforts to engage individual members/clients.
• Collects information necessary to develop an accurate assessment of each client/member.
• Completes timely and thorough assessments, care plans, service plans, and treatment plans.
• Provides linkage to community resources, as needed, such as homemaker/PA service, emergency alert systems, home delivered meals, durable medical equipment, food pantries, utility assistance, physical healthcare, behavioral healthcare.
• Engages the client/member's family and personal support team.
• Ensures members/clients get the assistance they need with ADL's and IADLS's and that they have the services in place to be safe living independently.
• Completes all necessary documentation in a timely and accurate manner and in compliance with established standards of the State of Illinois, Managed Care Organizations, related contracts, and TrilliumPlace.
• Provides members/clients with disease management information as needed.

Key Accountability

• Participates in in-service and competency training.
• Prepares special reports as needed.
• Meets clinical productivity standards/program deadlines.
• Meets compliance standards for all documentation and clinical charts.
• Works collaboratively with team members.
• Participates in supervision and team meetings.