Provides general case management including intake and referral services to all residents needing such assistance.
Provides formal case management (i.e. evaluation of health, psychological and social needs, development of an individually tailored plan for services and periodic reassessment of the resident's situation and needs) for a resident when such service is not available through the general community.
Establishes linkages with all agencies and service providers in the community; shops-around to determine/develop the best "deals" in service pricing to assure individualized, flexible, and creative services for the involved residents.
Facilitates meeting of needs when necessary but avoids the creation of unhealthy dependence.
Uses the least drastic intervention necessary to alleviate a problem situation.
Sets-Up a directory of providers for use by both project staff and residents. May also set-up volunteer support programs with service organizations in the community.
Refers and links residents, of the project, to service providers in the general community; for example, case management, personal assistance, Visiting Homemakers, Meals-on-Wheels, transportation, counseling, occasional visiting nurse, preventative health screening/wellness, and legal advocacy.
Educates residents on service availability, application procedures, client rights, etc., providing advocacy as appropriate.
May develop case plans in coordination with assessment services in the community.
Monitors the ongoing provision of services from community agencies and keeps the case management and provider agency current with the progress of the individuals. Manages the provision of supportive services where appropriate.
Helps residents build informal support networks with other residents, family, and friends.
May provide training to project residents in the obligations of tenancy or coordinate such training.
May educate other staff on the management team on issues related to aging in place and service coordination, to help them better work with and assist residents.
Reports all suspected abuse situations to the Housing Manager.
Documents contact with residents, providers, and families.
Maintains individual files on residents which will contain at least the following: intake information, service termination information, quarterly review and follow-up, human or civil rights abuse, and resident/family meeting notes.
Maintains Resident files in a locked cabinet to ensure confidentiality.
Completes reports with copies given to the Housing Manager, Quality Assurance Monitor, and government agency (where applicable) in an accurate and timely manner or according to governing regulations.
Pursues avenues for additional services through private, local, state, and federal sources.
Creates a service management plan as appropriate.
Performs other job-related duties, as requested.
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