Description

Job Summary: Coordinates and develops monitors the assessment, care planning process and follow up for each consumer, serves as an advocate and liaison for and on behalf of consumer’s benefits.

Essential Functions:

1. Maintaining current documentation of the consumer’s eligibility for waiver services, copies of the consumer’s individual service plan, and individual budget, financial data and related information, managing consumer records, ISPs, meeting with consumers, documenting via service notes.
2. Collaborate with consumers, caregivers, physicians and other providers to develop a comprehensive ISP/SAF.
3. Conducting intake and assessments for new consumers as well as year for existing consumers.
4. Knowing each consumer on a personal basis and being aware of the consumer’s strengths and weaknesses, and the consumer’s general plans to achieve his/her desired lifestyle.
5. Monitoring the health and welfare of the consumer and the quality of services provided to the consumer through personal visits and telephone calls.
6. Linking the consumer to all needed medical services regardless of the source of payment.
7. Assisting consumers in identifying contractors/vendors for environmental modifications and specialized medical equipment who meet provider qualifications. Providing follow-up with selected contractors and assuring consumer satisfaction. Documenting as required.
8. Ensuring that each consumer has a comprehensive Person Centered ISP and accurate individual budget.
9. Reviewing & updating the ISP/SAF once a year or more frequently if needed.
10. Adheres to Agency code of ethics and complies with the Federal, State and Agency Mandated Regulations/guidelines/standards applicable to the HCBS Waivers, Aging Waiver and Autism waiver, including complying with all reporting requirements and general standards of the waivers.
11. Function as a liaison to external agencies and shares information to others, which may impact care and/or services of consumers
12. Accurately identify and prioritize at risk consumers
13. Effectively communicate ISP/SAF plans and other consumer related activities both verbally and in writing to appropriate sources.
14. Coordinate preventative opportunities/measures promote early identification and interventions
15. Identify, report, and address quality issues through observation and data sources.
16. Complies with the agency standard for service coordination/case management.

Additional Responsibilities:

1. May be responsible for providing field instruction for peers of his or her respective professional discipline as opportunities permit. 
2. Performs additional related duties as assigned by the Supervisor.
3. Occasional overnight for trainings/seminars
4. Extensive travel within local area

Knowledge, Skills, and Abilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Advanced knowledge acquired by a prolonged course of specialized intellectual instruction and requiring consistent exercise of discretion and judgment. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Skills in working with or providing services for individuals with disabilities and/or special needs, traumatic brain injuries, autistic and the chronically mentally ill population, as well as skills in diagnosis and assessment and a commitment to the consumer control philosophy.
2. Ability to work as part of a comprehensive service and health orientated team and to represent the Agency in the community.
3. Familiarity with community support systems, health care and human service resources, court and police activities, etc.
4. Good organizational skills and administrative abilities.
5. Ability to successfully operate a personal computer and sustain a working knowledge of required software.
6. Ability to adhere to the professional code of ethics.
7. Knowledge of and ability to comply with the Federal, State and Agency Mandated Regulations/Guidelines/standards applicable to HCBS Waivers and Autism waivers.

Education and Experience

1. Educational Requirements: Bachelor’s degree (B.A.) from a four-year college or university in a Social or Human Services or related field is required (i.e. social work, psychology, etc.).
2. At least one (1) year professional experience in resource management or one (1) year professional experience in rehabilitation.
3. One (1) year of experience in working with individuals with traumatic brain injury (TBI) preferred.