Geriatric Care Manager

Job Description

Job Description

POSITION SUMMARY :

The Bilingual Geriatric Support Services Coordinator (GSSC) is the care manager assigned to work with SCO enrollees and is a member of the Primary Care Team (PCT). With the SCO Program Coordinator, the Bilingual GSSC is responsible for coordinating and providing community social services to SCO enrollees through the SCO’s policies, procedures, and practices. (Senior Care Options Programs : United Health Care)

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES :

• As a member of the Primary Care team (PCT), participate in Initial and Ongoing Assessments of the health and functional status of enrollees and develop community-based care plans and related service packages necessary to improve or maintain an enrollee’s health and functioning.
• Arrange, coordinate, and authorize the provision of appropriate long-term care and social support services for enrollees (with the agreement of the PCT and by requirements set forth by the SCO). These may include but not be limited to : ADL and IADL assistance; Housing; Home-delivered Meals; and Transportation.
• Monitor the appropriate provision and functional outcomes of community long-term care services that have been authorized by the PCT.
• Track enrollee transfers and adjust service plan as deemed appropriate by the PCT and by requirements set forth by the SCO.
• Provide care management services via the telephone as requested by SCO RN.
• Prepare documentation for enrollee files, agency database, and for SCO Coordinator to submit to SCO RN.
• Perform all services by state and federal law and written SCO management protocols, including timely entry of all information required to be included in Centralized Enrollee Records (CER).
• Maintain care management documentation as specified in SCO care management protocols.
• Report suspected Fraud, Waste, and Abuse (FW&A) as required by CBES FW&A policy.
• Protect Consumers’ Personal Health Information (PHI) and report any suspected security breaches.
• Respond promptly to enrollee service requests.
• Attend and participate in PCT, agency, and departmental meetings and trainings as required.
• Other duties as assigned.

QUALIFICATIONS :

Ability to speak and write fluently in English and one of the following foreign languages : Chinese, preferred.

EDUCATION, SKILLS, AND EXPERIENCE :