Summary:
Service Coordinator assists participants who need LTSS in obtaining the services they need as required by CHC. Contributes to the LTSS care coordination process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of participant’s needs, including physical health, behavioral health, social services and long-term services and supports. This includes the ability to identify, provide and maintain regular supports to assure continuity of care while maintaining compliance with all contract and funding regulations.
Essential Responsibilities:
- Lead the participant-centered planning and service (PCPS) delivery process and oversee its implementation.
- Identify, coordinate, and assist participants in gaining access to needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.
- Provides information to participants and facilitates access to, locating, coordinating, and monitoring needed services and supports for Participants.
- Informs participants about available LTSS required needs assessments, the PCSP process, service alternatives and service delivery options.
- Informs participants of their rights and assists with the complaint, grievance, and DHS Fair Hearing processes.
- Collects additional necessary information, including participant preferences, strengths, and goals to inform the development of the PCSP.
- Conducts reevaluation of level of care annually or more frequently as needed in accordance with CHC requirements.
- Completes required quarterly visits. Due to nature of pop-up visits and/or triggering events, driving to multiple consumers’ homes in multiple counties at any given time could occur during business hours.
- Completes required monthly contacts.
- Works with the participant to complete activities necessary to maintain LTSS eligibility.
- Advocate for continuity of services, system flexibility and integration, proper utilization of facilities and resources, accessibility and participant rights.
- Participate in any Department identified activities related to quality oversight.