Transition Navigator - Monroe, Washtenaw, Livingston Counties

General Description:

The Transition Navigator provides direct service to Medicaid recipients residing in nursing facilities, who desire to live in the community. This position focuses on Nursing Facility Transition and is responsible for writing Person Centered Transition Plans and coordinating consumer transition services from the nursing facility to the community and providing monthly support coordination prior to and follow-along services after consumers move back into the community.

This is a full-time remote position serving Livingston, Monroe, and Washtenaw Counties. Travel is required to Troy for staff meetings.

Major Responsibilities:

Shadow current Transition Navigators to learn processes;

Interview nursing home residents who express an interest in returning to their home or other community-based setting;

Provide education about transition services to individuals, informal supports and facility staff, provide an initial assessment of interested individuals, submit information to MDHHS through the NFT Portal for approval;

Develop a person-centered service plan for each participant approved by MDHHS in the NFT Portal;

The transition navigator will connect individuals with home and community-based programs or services of their choice before transition and will assure a smooth transition to the community;

Shop for needs of consumer before transition;

Assist in setting up consumers’ new home, including delivering groceries, household supplies, and other equipment.

Perform home inspection prior to transition to ensure safe transition to community;

Provides follow-along services after the transition to support independent living;

Meet with family members and others who may have a role in planning the transition and providing community supports;

Report all critical incidents that occur with NFT participants to MDHHS using the critical incident database;

Contribute to and participate in all fundraising activities (including raising funds) in support of DNEM mission and values;

Track relevant service and outcome information for grant reporting purposes for and complete reports/ paperwork as required;

Enter all data in database in timely manner;

Attend DNEM staff meetings, events and other activities as required;

Other duties assigned by the Community Transition Services Director, Associate Director and/or Chief Executive Officer.

Qualifications:

Education & Experience

Minimum of Bachelor’s Degree in Social Work, CHW certification required or Bachelor's Degree in Human Service field with 3 years experience required;

One to three years working within the disability community or human services field is preferred.

Expected Skills and Attributes

Must be able to efficiently navigate multiple technology and documentation platforms on a daily basis.

Ideal candidate will have proficient electronic documentation experience.

Must be a highly organized self-starter;

Ability to follow direction and take initiative with exceptional time management and organizational skills;

Commitment to and knowledge of Independent Living movement and philosophy and person-first perspective which supports DNEM’s mission and core values;

Must be detail oriented and able to balance multiple tasks to support numerous communication functions throughout the organization;

Interpersonal skills and ability to participate in and work to build a collaborative team;

Be able to work collaboratively and independently in a fast-paced, passionate, structured and diverse environment;

Must be able to travel in DNEM’s service territory;

Willingness to learn and apply new concepts.

Disability Network Eastern Michigan is an Equal Opportunity/Affirmative Action Employer, people with disabilities and minorities are strongly encouraged to apply for this position.

Please email resumes to hlauwers@dnemichigan.org fax to 586-285-9942. No phone calls will be accepted.

Job Type: Full-time

Pay: $21.00 - $23.00 per hour

Benefits:

• 401(k) matching
• 403(b)
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Vision insurance

Education:

• High school or equivalent (Preferred)

Experience:

• Health & Human Services : 1 year (Required)

Willingness to travel:

• 25% (Preferred)

Work Location: Hybrid remote in Troy, MI 48083

Salary : $21 - $23