Purpose: This is a full-time, grant-funded 35-hour/week position. Under the direction of the Associate Director, targeted Health Care Case Management is delivered that addresses all the domains of social determinants of health. This position is a direct service position supporting people in our public housing sites within Allegheny County toward self-sufficiency, housing stabilization and reduced risk of adverse health outcomes.
Essential Job Functions:
• Must be able to work independently, moving ACHA residents in the direction of independence by encouraging self-determination, and self-evaluation and consistently assisting ACHA residents to recognize their own strengths and using those strengths for personal growth
• Must demonstrate a strong work ethic and a high level of integrity
• Provide direct services to recipients within ACHA for the purpose of outreach, intake and assessment, education, and/or referral for identified Social Determinants of Health (SDOH) needs
• Maintain an active caseload of at least 40 individuals within the ACHA portfolio
• Must maintain confidentiality and provide information within agency guidelines and on a need-to-know basis
• Provide services in an empathic, hopeful, and welcoming manner
• Complete all documentation and data collection in accordance to State and agency requirements including intake, assessments, data entry, and progress notes
• Prepare and maintain all necessary documents for the case file and insurance provider reporting.
• Provide education and linkage to Medical Assistance providers and support the development of living skills that will improve health outcomes
• Enhance coordination of services for behavioral and physical health with local Medicaid insurance providers
• Engage Community-Based Organizations as part of an integrated holistic approach to person-centered care and education
• Work collaboratively with the CBCM Associate Director to identify interventions and resources available that increase Health literacy and reduce the risk of utilization of acute services
• Develop and maintain a comprehensive list of local and state resources that address each domain of Social Determinants of Health, with a focus on street medicine, harm reduction and preventative screening best practices
• Foster Cross-Departmental collaboration to help identify community-level needs and produce outcome deliverables
• Ability to demonstrate time management, team collaboration, and professional written and verbal communication skills
• Ability to demonstrate critical thinking and problem-solving to determine the best plan for each individual on their caseload
• Provide quarterly and annual follow-up to ensure individuals served were satisfied with services and have maintained the resources provided
• Communicate with other team members and program manager about resident progress and needs
• Participate in scheduled supervisions to provide and accept feedback and identify opportunities for continued professional development
• Develop individualized treatment plans with each resident to further develop their ability to live independently in the community
• Obtain Advanced First Aide and CPR certification within 6 months of employment
• Must have and maintain a valid PA driver’s license and use of a personal vehicle.
Required Education/ Experience: Bachelor’s Degree in Social Work, Psychology, Nursing, OR no degree and minimum of 4 years of demonstrated relevant experience.
Experience Preferred: Compiling and sorting date, entering raw date into database. Proficient in various programs to include, but not limited to: Microsoft Outlook, Word, and Excel. Demonstrated knowledge and experience in the provision of community social services, insurance benefit navigation and continuum services of care.
Physical Requirements: Work is performed both in office settings and community settings. Must be physically able to access various physical locations on and off ACHA. Must have a level of manual dexterity sufficient to allow for the operation of a computer, telephone, fax machine, calculator, etc. Ability to move, handle or lift small objects around desk area, i.e. files, computer printouts, reports, calculator, office supplies, etc.
McKees Rocks PA United States