Geriatric Support Services Coordinator (Bilingual In Spanish) #817

Elder Services of the Merrimack Valley and North Shore

Position Overview:The Geriatric Support Services Coordinator (GSSC) coordinates supportive services for elders living in the community who are enrolled in a Senior Care Options (SCO) program. GSSC works closely with interdisciplinary members of the SCO's Primary Care Team (PCT). This position is responsible for all aspects of support services case management for an elder client caseload including needs assessment, service plan development, service authorization, and monitoring the service needs of SCO members.
Essential Job Functions:
Coordinates initial and ongoing assessments for SCO members, including the Primary Care Team (PCT) in assessment activities as appropriate.

Conduct field visits to assess an older adult's physical, social, emotional and environmental status to determine their eligibility and needs in their homes in accordance with contract compliance.

Coordinates the development of the community-based care plan and related service package necessary to maintain or improve the health of members, in collaboration with the SCO PCT.

Monitors the appropriate provision and functional outcomes of community services, adjusting them as needed, and coordinating services with CHHAs, DMH and other service providers to ensure timely and non-duplicative service delivery.

Participates in discharge planning activities to support members returning to the community.

Participates in SCO PCT meetings and case review to ensure continuity of care.

Maintains accurate and timely documentation in centralized record keeping.

Attends in-service training, other seminars, and programs appropriate or beneficial to the GSSC position.

Work collaboratively within the team when difficult scenarios and issues arise within a teammate's caseload.

Non Essential Job Functions:
Participates in outreach to the community when appropriate.

Requirements:BSW or Bachelors' Degree in Human Services and two years' experience working with elders. Bilingual capacity in Spanish required. Must have a valid MA driver's license and a vehicle.LSW license or eligibility for a license preferred. MSW and LCSW preferred.
Experience:Knowledge of elder care network required. Experience in a health care setting preferred.

Skills:
Ability to effectively participate in an interdisciplinary team environment.
Excellent communication and documentation skills.
Up-to-date awareness of agency and community services and resources.
Flexibility and creativity in service planning

Hours:37.5 per week
AA/EOE