What are the responsibilities and job description for the MICH Support Coordinator, SW – Independent Contractor Only position at Detroit Area Agency on Aging?
Essential Duties and Responsibilities
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Conducts face-face assessments/reassessments from a clinical perspective on designated assigned cases.
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Obtain medical history and document pertinent clinical information from participants related to their medical diagnoses and assessment findings.
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Utilizing assessment, develops a plan of care directed by the client (Person Centered Care Planning)
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Monitor participants for conditional changes associated with their physical and mental health well-being.
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Performs monthly medication reconciliations.
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Develops and completes care plans and other required documents. Reviews and modifies care plans as directed by the client / caregiver during the reassessment and obtains the clients signature of approval.
Communication:
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Maintains regular, ongoing contact with clients, caregivers, physicians and service providers listed on service plan through home visits and phone calls.
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Educates clients, caregiver and service providers regarding the roles and responsibilities of each party, assuring that services are provided as documented in the care plan.
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Conducts Nursing Facility Level of Care assessment as required.
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Continues to evaluate the appropriateness of the service plan, adjusting it as needed.
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Monitors client progress in relation to goals and objectives listed in the care plan.
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Interfaces with community resources as needed to support client.
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Collaborates with peers (RN or SW) in coordinating services.
Develop and Monitor Care Plan:
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Produces timely and accurate commuter entry reports.
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Maintains client confidentiality.
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Participates in training, supervisory meetings, in-services and continuing education opportunities.
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Abides by DAAA’s and Waiver Codes of Ethics.
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Participates in other duties as assigned.
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Computer literate: Word, Excel, Outlook
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Excellent communication skills, written and verbal.
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Current Michigan driver’s license and access to a car.
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Ability to analyze and solve problems.
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Must be able to maintain a caseload of 150 cases.