Job Summary:
Provides Quest Integration (QI) care coordination to identified members (Adult, Senior and Child) with special health care needs, using face to face/in home Health Functional Assessment (HFA). Develops a client focused QI service plan collaboratively with primary care physician (PCP) and other decision makers. Assists with access to medical care and services. Coordinates Home Community Based Services (HCBS) as needed. Communicates and coordinates health care services needed with Care Management Associates, professional health team members and community agencies. Assists families in crisis. Promotes Early and Periodic Screening, Diagnosis and Treatment (EPSDT) compliance.
Essential Responsibilities:
- Provides care coordination across the continuum, by assessing health care and appropriate HCBS by performing a comprehensive face to face/in home Health Functional Assessment within 15 days of notification. Completes a client (member) focused Service Plan within 15 days of the assessment.
- Maintains required documentation using KPHC electronic health record. Updates members service plan progress, documents assessments and medical care to indicate progress, changes and continuity of care.
- Provides information, resource identification and referral services including but not limited to dental for preventative and restorative care, Social, Emotional, and Behavioral Difficulties (SEBD)/Severely Mentally Ill (SMI), child welfare services, Adult Protection Services (APS), and Developmental Delayed/Intellectual Disability (DD/ID).
- Serves as resource person to members, families, physicians, staff and community agencies and institutional facilities, for matters pertaining to health care services, community living, appropriate placement setting, and/or request for self-directed services.
- Works closely with Member Care Services Associate to navigate HCBS, supplies and equipment for our members.
- Conducts social work consultation and resource development.
Basic Qualifications:
Experience
- One (1) year social work experience.
Education
- Masters degree in social work OR a minimum six (6) years of experience in a directly related field.
License, Certification, Registration
- Licensed Clinical Social Worker (Hawaii) OR Licensed Social Worker (Hawaii)
- Basic Life Support required at hire from American Heart Association
Additional Requirements:
- Demonstrated knowledge of and skill in oral communication, written communication, problem solving/assessment, teamwork, team building/team leader, group process facilitation, statistical data analysis, documentation accuracy, customer service, interpersonal relations, creativity/innovation, adaptability, decision making, and conflict resolution.
Preferred Qualifications:
- One (1) year of care coordination/case management experience preferred.
- Home health experience preferred.
- Healthcare experience working with medical diagnoses preferred.
- Demonstrated ability in networking with community agencies preferred.
