Provides Quest Integration (QI) care coordination to identified members (Adult, Senior and Child) with special health care needs, using face to face/in home Health Functional Assessment (HFA). Develops a client focused QI service plan collaboratively with primary care physician (PCP) and other decision makers. Assists with access to medical care and services. Coordinates Home Community Based Services (HCBS) as needed. Communicates and coordinates health care services needed with Care Management Associates, professional health team members and community agencies. Assists families in crisis. Promotes Early and Periodic Screening, Diagnosis and Treatment (EPSDT) compliance.
- Provides care coordination across the continuum, by assessing health care and appropriate HCBS by performing a comprehensive face to face/in home Health Functional Assessment within 15 days of notification. Completes a client (member) focused Service Plan within 15 days of the assessment.
- Maintains required documentation using KPHC electronic health record. Updates members' service plan progress, documents assessments and medical care to indicate progress, changes and continuity of care.
- Provides information, resource identification and referral services including but not limited to dental for preventative and restorative care, Social, Emotional, and Behavioral Difficulties (SEBD)/Severely Mentally Ill (SMI), child welfare services, Adult Protection Services (APS), and Developmental Delayed/Intellectual
- Serves as resource person to members, families, physicians, staff and community agencies and institutional facilities, for matters pertaining to health care services, community living, appropriate placement setting, and/or request for self-directed services.
- Works closely with Member Care Services Associate to navigate HCBS, supplies and equipment for our members.
- Conducts social work consultation and resource development.
- One (1) year social work experience.
- Master's degree in social work.
License, Certification, Registration
- Valid Hawaii Social Worker license (LSW) and/or Clinical Social Worker license (LCSW) (must meet education requirement(s) for Hawaii State licensure).
- Current BLS for Healthcare Provider CPR or CPR/AED for the Professional Rescuer certification upon hire.
- Demonstrated knowledge of and skill in oral communication, written communication, problem solving/assessment, teamwork, team building/team leader, group process facilitation, statistical data analysis, documentation accuracy, customer service, interpersonal relations, creativity/innovation, adaptability, decision making, and conflict resolution.
- One (1) year of care coordination/case management experience preferred.
- Home health experience preferred.
- Healthcare experience working with medical diagnoses preferred.
- Demonstrated ability in networking with community agencies preferred.