Care Coordinator - AgeSmart

POSITION: Care Coordinator 

The Care Coordinator manages the delivery of care to AgeSmart members and Summit residents. Maintains a working knowledge of all resources for seniors in our market area, including services provided by AgeSmart and services not covered by the Plan. Manages the delivery of care, programs, services, support groups, and care transitions to ensure residents receive care appropriate to their individual needs.

GENERAL QUALIFICATIONS

• College degree or RN with at least 5 years of experience working with seniors in a healthcare environment.
• MSW preferred, but not required
• Experience in case management or related field with the senior population including demonstrated skills in planning, organizing and developing effective systems.
• Familiarity with updated clinical assessment methods and community resources.
• An understanding of reimbursement criteria for Medicare.
• Excellent interpersonal skills with demonstrated ability to interact and communicate effectively with members, staff, vendors, professional community and others.
• Strong commitment to quality care and service and sensitivity to the needs and concerns of seniors.
• Knowledgeable of the aging process and the physical and psychosocial needs of seniors.
• Computer skills, especially proficiency with Microsoft Office Suite and Sharepoint.
• Valid Driver’s License
• Criminal History Clearance
• Motor Vehicle Driving History Clearance

BENEFITS: 

• Medical, Vision, Dental
• PTO
• Employer Retirement Contribution 4.5%
• HSA Match
• Tuition Reimbursement
• Supportive Environment and Leadership
• Amazing residents and collaborative teams!
• Access to early earned wages

ESSENTIAL JOB FUNCTIONS

• Supports the Mission, Vision and Values of LifeSpire of Virginia as a true servant leader to all members and staff.
• Schedules and completes pre-admission assessments of prospective members of AgeSmart which may include a cognitive assessment, functional assessment, depression screen, nutritional and home assessment and level of care guidelines (ADL’s/IADL’s) on an as needed basis.
• Maintenance of individual vendor files and the referral process.
• Manages a caseload of members in AgeSmart, including regular communication with members, assessments of needs, coordinating and scheduling services (both provided by the Plans and those not provided by the Plan).
• Initiates the member’s care plan and maintains detailed records of all member activity in the member’s file and EHR system for AgeSmart members.
• Assists Summit residents and/or their families to gain access to care and services as needed in the location of their choosing.
• Assist the marketing and care teams to admit/transfer residents to higher levels of care.
• Activates care coordination for AgeSmart members and supervises the provision of care rendered by the credentialed vendor.
• Assists in the coordination of therapy, home care, transportation, etc for independent living residents.
• Assists Summit residents to coordinate movement through the levels of care on campus by monitoring “high risk residents” or “residents of concern”
• Verifies hours of care provided for.
• Maintains up-to-date files on all resources available in the community for seniors.
• Represents AgeSmart and The Summit at professional meetings, networking opportunities, community organization meetings etc.
• Maintains files that adequately record activity related to Member services to be used as a history for reporting, quality assurance measurements, new program offerings and other information as needed.
• Compiles a monthly report including, but not limited to, visits, amount of service provided by category, QA results, etc.
• Ensures that the confidentiality of member information is protected and always maintained.
• Monitors members’ satisfaction regularly to ensure the protection of AgeSmart’s reputation.
• Other tasks as assigned

WORKING HOURS:

General schedule is 8:30 – 5:00pm. Will need to attend evening functions on occasion. Will participate in the on-call rotation for evenings, weekends and holidays. Responds to after-hours emergencies on rare occasions, as needed.

We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.