Support Coordinator RN
4 weeks ago
Description
Conducts face-face assessments/reassessments from a clinical perspective on designated assigned cases.
Obtain medical history and document pertinent clinical information from participants related to their medical diagnoses and assessment findings
Utilizing assessment, develops a plan of care directed by the client (Person Centered Care Planning)
Monitor participants for conditional changes associated with their physical and mental health well-being
Preforms monthly medication reconciliations
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.
Maintains regular, ongoing contact with clients, caregivers, physicians and service providers listed on service plan through home visits and phone calls.
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.
Conducts Nursing Facility Level of Care assessment as required.
Continues to evaluate the appropriateness of the service plan, adjusting it as needed.
Monitors client progress in relation to goals and objectives listed in the care plan.
Interfaces with community resources as needed to support client.
Collaborates with peers (RN or SW) in coordinating services.
Produces timely and accurate commuter entry reports.
Maintains client confidentiality
Participates in training, supervisory meetings, in-services and continuing education opportunities.
Abides by DAAA's and Waiver Codes of Ethics.
Participates in other duties as assigned.
Requirements
Education:
Possess a Registered Nurse License in the State of Michigan
Experience:
Two-three years of experience completing intakes, pre-screening, and/or assessments, preferably in a health care or human service setting serving the elderly and/or disabled population.
Knowledge of Medicaid and Medicare regulations.
Ability to complete assessments using computerized screening tools.
Excellent Customer Service skills and ability to de-escalate callers.
Computer literate: Word, Excel, Outlook
Excellent communication skills, written and verbal
Current Michigan driver's license and access to a car.
Ability to analyze and problem solve.
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