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NHTD / TBI Service Coordinator

Elite Home Health Care
Brooklyn, NY Full Time
POSTED ON 11/23/2025
AVAILABLE BEFORE 2/4/2026
About Elite
Elite Home Health Care is a licensed home care agency that provides professional homecare services in the New York Metropolitan area, Central, and Upstate NY Regions. At Elite, we only hire the most qualified nurses, home health aides and caregivers who are hand-picked based on their skills and capabilities. They are all licensed, insured and cleared with extensive background screening. But most importantly, our caregivers are known for their warmth, attentiveness and reliability. Our main goal is to deliver compassionate, professional, and integrity-centered care to our clients. We work within the community to provide quality home care for individuals in need.  We are committed to providing our clients with the best possible and most compassionate care!

Job Summary
Service Coordination is an individually designed intervention which provides primary assistance to the waiver applicant/participant in gaining access to needed waiver and Medicaid State Plan services, as well as other local, state and federally funded educational, vocational, social and medical and any other services to Participants of the NHTD and TBI Medicaid Waiver Programs. These interventions are expected to result in assuring the waiver participant’s health and welfare and increasing independence, Community Integration and productivity.  The Senior Service Coordinator / SC Supervisor will assist the applicants/participants in obtaining and coordinating the services that are necessary to return to or remain in the community.

Essential Duties and Responsibilities:  
•    Formally reviewing, updating, and submitting services plans to the RRDS for review, both initially and annually thereafter.
•    Organizing and facilitating team meetings twice a year for each participant, and additionally as needed.  
•    Maintaining Participant files in accordance to Waiver Requirements, including all necessary documentation from enrollment, as well as annual service plans and addenda.
•    Assuring completion of a UAS on, at minimum, an annual basis.  
•    Maintaining records of waiver transportation as described in the manual section on transportation services, including obtaining approval for Social Transportation.
•    Scheduling Transportation for participants for medical appointments.
•    Assuring that all waiver service providers and the participant receive a current copy of the most recently approved service plan.
•    Maintaining a copy of RRDC issued Provider List.
•    Conducting Monthly Face-to-Face visit on a monthly basis to allow for monthly SC billing (per manual this visit must occur in the participant’s home at least quarterly)
•    Enrolling applicants onto the NHTD / TBI Medicaid Waiver through the enrollment (ISP) process.  
•    Assuring that the service plan is implemented appropriately and in accordance to the approved service plan.  
•    Supporting the participant to become an effective self-advocate and problem solver by supporting them and their needs and helping to foster their independence.
•    Acting as an effective advocate for the participant.
•    Providing ongoing support and assessment of needs and potential needs of additional waiver services.  
•    Maintaining quality assurance.
•    Conducting and participating in the Housing Audit, annually, for any participants on the caseload who are in receipt of the NHTD or TBI Housing Subsidy
•    Tracking and Maintaining participant Lease Renewal dates and obtaining appropriate documentation for Lease Renewal and Housing Subsidy Renewals on an annual basis (at time of lease renewal).
•    Monitoring and assisting with all applications and renewals for all benefits and entitlements, including but not limited to: SNAP, Medicaid, HEAP, Etc.
•    Ordering supplies through DME Companies as needed

In addition to All Regular SC Duties for participants on their direct case load, the SC Supervisor / Senior SC is responsible for: 

•    Tracking Service Plan Approval / Expiration Dates of all Agency Participants in receipt of Service Coordination 
•    Tracking all Monthly Visits, and ensuring Visits are consistently being completed by SC’s
•    Monitoring and overseeing all housing audit participants for the agency and creating their budget periods / referral periods in the Housing Portal for DOH 
•    Training Newly Hired Service Coordinators
•    Reviewing and signing off on all Service Plans (Both Initial (ISPs) and Annual/ RSPs)
•    Tracking UAS Dates of expirations
•    Conducting ongoing and regular supervision meetings with All Service Coordinators. 
•    Providing Support to the Service Coordinators 
•    Providing Support to the VP Of Waiver Services
•    Assist with troubleshooting Medicaid Issues for SC Participants 
•    Other duties as assigned

Qualifications and Skills: 
Qualifications (per Waiver Manual):
•    Licensed Master Social Worker (Licensed by the NYS Education Department);
•    Licensed Clinical Social Worker (Licensed by the NYS Education Department);
•    Individual with a Doctorate or Master of Social Work;
•    Individual with a Doctorate or Master of Psychology;
•    Individual with a Master of Gerontology;
•    Physical Therapist (Licensed by the NYS Education Department);
•    Registered Professional Nurse (Licensed by the NYS Education Department);
•    Certified Teacher of Students with Disabilities (Certified by the NYS Education Department);
•    Certified Rehabilitation Counselor (Certified by the Commission of Rehabilitation Counselor Certification);
•    Licensed Speech Pathologist (Licensed by the NYS Education Department); 
•    Occupational Therapist (Licensed by the NYS Education Department); OR 
•    Have successfully served as a Regional Resource and Development Specialist for a minimum of 1 year.
•    An individual meeting any of the qualifications above must also have, at a minimum, 1 year of experience providing case management/service coordination and information, linkages, and referrals regarding community-based services for individuals with disabilities and/or seniors.
•    Be an individual with a Bachelor’s Degree and 3 years of experience providing case management/service coordination, information, linkages, and referrals regarding community-based services for individuals with disabilities and/or seniors.
•    Be an individual with an associates degree and 5 years of experience providing case management/service coordination, information, linkages, and referrals regarding community-based services for individuals with disabilities and/or seniors 

Work Environment:
Hybrid


Pay Range: The hiring range for this position is $70,000.00-80,000.00 annually. Various factors will determine final compensation, such as a candidate’s years of relevant work experience, skills, certifications, and location.

EHC1000
 

HouseWorks, LLC and its Family of Companies is an Equal Opportunity Employer. We do not discriminate against race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability or genetic information.

Salary : $70,000 - $80,000

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