Full-Time Service Coordinator- Licensed Clinical Social Worker
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Job Description
The Company:
AlohaCare is a local, non-profit health plan which serves approximately 50,000 health plan members through well-established partnerships with over 2,200 quality health care providers and community-governed health centers. In the true spirit of Aloha, AlohaCare supports, cares and serves the health care needs of Hawaii’s residents and specializes in care for the medically underserved and medically fragile. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.
The Culture:
AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.
AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare’s strong commitment to support local Hawaiian families is practiced with our employees by reinforcing a healthy work/home balance. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, monthly appreciation events, quarterly all-staff meetings and annual galas. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.
These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.
The Opportunity:
Job Summary:
The Service Coordinator is responsible for conducting face-to-face assessments, developing individualized service plans, interacting with members, providers, and physicians to coordinate primary, acute, behavioral, and long term services and supports (LTSS) for individuals having special health care needs. Job functions are performed in accordance with requirements of the QUEST Integration contract and health plan goals and quality outcome metrics.
Primary Duties and Responsibilities:
- Conducts face-to-face Health and Functional Assessments (HFA) for all members on an annual or more frequent basis (as applicable) and/or a Level of Care Assessment (DHS Form 1147) for member needing long term care
- Engages member/providers to participate in the assessment process and collaboratively develop a Service Plan for each member, based upon the HFA, DHS-1147, or other forms.
- Interacts with member, family, physician(s), and other providers utilizing clinical and social knowledge and expertise to determine the member’s current status and capacity and to assess the options for service delivery including use of health plan benefits and community resources to update a Member’s Service Plan.
- Coordinates member access to community resources with other sources of care, Primary Care Physicians, specialists, family members, and other health providers, with emphasis on the development of natural support system in coordination with health plan benefits and other public programs.
- Facilitates member choice.
- Facilitates member and provider authorization and access to services.
- Monitors and resolves any concerns about service delivery or providers and to ensure that the services being provided are meeting the member’s needs.
- Provides individualized education on preventative health care measures and HCBS alternatives to nursing facility placement.
- Monitors and performs service coordination activities for members in self-direction program.
- Assists members in transitioning between hospital, nursing facility, other congregate settings and other community-based locations.
- Refers members with suspected severe emotional, behavioral and/or mental illness for evaluation and treatment.
- Maintains accurate written documentation and records of service coordination activities in computer system according to appropriate service coordination and/or clinical guidelines.
- Ensures compliance with all state and federal regulations, including HIPAA standards of confidentiality of protected health information, reporting of critical incidents and reporting of quality of care issues.
- Performs other duties as assigned.
Required Competencies and Qualifications:
- Minimum 1 year relevant experience
- Must be organized and detail-oriented
- Must possess strong written and verbal communication and presentation skills in English
- Demonstrates knowledge of regulations and standards specific to home care and long term services and supports program management.
- Demonstrates competency with administrative skills, including knowledge of state, federal, and accrediting body regulations and licensure requirements.
- Demonstrates competency in assessment, analytical skills and the development, coordination and implementation of a home care plan
- Must possess a diverse perspective that is sensitive to cultural, emotional and religious differences
Required Licensure/Certification/Education:
- Associates degree in Health Care Administration, Nursing, Long Term Services and Supports, Public Health, or related field
- Licensed SW in State of Hawaii
- CPR Certification
Preferred Qualifications:
- Bachelor’s or Master’s Degree in Health Care Administration, Nursing, Long Term Services and Supports, Public Health, or related field
- Multilingual preferred
- Experience with serving Quest members in the community
- Health plan experience with care coordination responsibilities
- Experience with Medicare / Medicaid programs
- Experience with individuals who have special health care needs, including: HIV/AIDS, developmental disabilities, medically-fragile, older adults, and individuals with physical disabilities
- Prior nursing home diversion or long term care case management experience serving Quest members in the community
- Previous experience in utilization management, discharge planning and/or home health or rehab
Physical Demands/Work Environment:
- Possession of a valid driver’s license and auto insurance with access to a reliable, 4-wheel, safety- inspected vehicle.
- 2-Step Tuberculin Skin Test
- Medium work: Walking, standing and exerting up to 40 pounds of force occasionally, or up to 25 pounds of force frequently, or greater than negligible up to 10 pounds of force constantly to move objects.
- May require prolonged sitting up to 4 hours.
- Requires operation of a computer workstation, including keyboard and video display terminal.
AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.
How to Apply:
For more information, please contact Josie Gesteuyala, HR Generalist
Phone: 808.973.6339
Email: jgesteuyala@alohacare.org
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