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Community Support Services Coordinator
2 months ago
AgeSpan
Formerly Elder Services of the Merrimack Valley/North Shore
About Our Organization: Since 1974, our agency has been dedicated to empowering individuals to make their own choices, maintain their independence, and live autonomously within their communities. We take pride in our team members who contribute to this mission daily. Our organization is recognized as a thought leader, fostering innovation and welcoming creative ideas. We provide a stimulating, friendly, and collaborative work environment. Our offerings include competitive compensation, generous leave policies, and a strong emphasis on work/life balance. We celebrate diversity and support career advancement. If you are passionate about enhancing the lives of the elderly and thrive in a diverse, mission-driven team, you have found your ideal workplace.
At AgeSpan, you will experience a work culture that includes:
- A supportive environment that values collaboration and diverse perspectives.
- A commitment to innovation with a team recognized for creating and executing groundbreaking programs and solutions.
- Opportunities for personal growth through involvement, expression of ideas, and acquisition of new skills.
- A healthy work-life balance, featuring flexible work arrangements, generous paid time off, and wellness initiatives.
Depending on your role and hours, we provide:
- Flexible scheduling and hybrid work options
- Competitive compensation
- Comprehensive healthcare benefits (medical, dental)
- 403b Retirement Plan with agency contribution
- 20 Vacation Days, 12 Sick Days, and 12 Paid Holidays
- Social Work Licensing Program
- Agency-funded license renewal for RNs and Social Workers
- Mileage reimbursement
- Complimentary parking
- Employee Referral Bonuses
- Employee Assistance Program
- Tuition Remission Program
- Subsidized gym membership (on-site)
- Commitment to internal promotions
Key Responsibilities: The Community Support Services Coordinator will operate within a healthcare setting, collaborating as an integral member of the case management team to optimize the discharge planning process. This role will assist patients in accessing Home and Community Based services while managing complex support needs.
Core Duties:
- Facilitate connections for individuals to Home and Community Based programs that aid in community discharge.
- Participate in Care Management team meetings, daily briefings, interdisciplinary rounds, and relevant conferences.
- Adhere to all organizational policies and procedures while present in the healthcare facility.
- Maintain confidentiality and security standards, including compliance with privacy regulations.
- Accept assignments from the case management supervisor or designated personnel.
- Engage with assigned patients and their families to provide support.
- Utilize the hospital's electronic medical record system to enhance communication with the care team.
- Access communication tools to facilitate care transitions between acute and community settings.
- Employ discharge planning resources currently utilized by the healthcare facility.
- Identify barriers to discharge and document findings in the electronic medical record.
- Coordinate necessary resources for a safe transition back to the community.
- Collaborate with healthcare staff, physicians, and community service providers to arrange necessary services for discharge.
- Initiate enrollment in community support programs for eligible patients.
- Follow up with patients post-discharge to ensure ongoing support.
- Review discharge plans to confirm that patient needs are being met.
- Conduct home visits to evaluate the living environment and available support systems.
- Assess patients' functional, health, and financial status to determine eligibility for community long-term care services.
- Complete needs assessments to identify challenges to independent living.
- Review medication management to ensure patients have access to necessary prescriptions.
- Assist in scheduling follow-up medical appointments and arranging transportation as needed.
- Address previously identified barriers to successful transitions.
- Monitor for any concerning signs and communicate with primary care providers as necessary.
- Establish a follow-up schedule that includes in-person and virtual contacts.
- Report any issues that may hinder the patient's ability to remain in the community.
- Collaborate with the medical team and community resources to resolve reported issues.
- Work collaboratively with other liaisons to ensure essential functions are covered.
- Provide training for healthcare staff on community-based alternatives to institutional care.
- Ensure compliance with all regulatory requirements of AgeSpan and relevant state and federal agencies.
- Maintain accurate documentation, including case files and statistical records as required.
- Participate in supervision, team meetings, and professional development opportunities.
- Engage in training and workshops to enhance professional skills.
- Perform additional duties as assigned.
Qualifications: A Bachelor’s degree in social work, human services, or a related field is required; experience in case management and working with older adults is preferred. An Associate’s degree with substantial relevant experience may be considered. Reliable transportation and a valid driver’s license are necessary due to the fieldwork component of the role. Candidates must be willing to obtain required immunizations.
Applicants should be prepared to conduct community assessments regularly and possess strong written, verbal, and interpersonal skills, along with the ability to thrive in a team-oriented environment.
Weekly Hours: 37.5
Equal Opportunity Employer:
AgeSpan is committed to fostering a professional environment that values and encourages the unique contributions of a diverse workforce. We strive to reflect the communities we serve and maintain a workplace that allows individuals from varied backgrounds to grow professionally and contribute to our mission through diversity, equity, inclusion, and work-life balance.
Job Posted by ApplicantPro