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Care Coordinator- Solano

ORGANIZATION: SHELTER, Inc. is an independent, community-based non-profit organization created in 1986 to lead the effort to eliminate homelessness. We currently operate in Contra Costa, Solano and Sacramento counties.

MISSION: To prevent and end homelessness among low-income, homeless, and disadvantaged families and individuals by providing housing services, support and resources that lead to self-sufficiency.

PURPOSE of ROLE: This position is responsible for consulting with participants and determining their wellness needs, providing medication monitoring and first aid services as needed. This position may also assist Case Managers in coordinating patient-care services.

RESPONSIBILITIES:

Consult with participants and their respective Case Managers to discuss health concerns.

Provide oversite to the medication monitoring process, and document all witnessed doses.

Support and guide participants to fill and refill prescriptions.

Work with participants for best options for their picking up medications from local pharmacies.

Establish relationships with local pharmacies for prescriptions, deliveries, and refills.

Point of contact with all Respite referrals from local hospitals.

Liaison with outside partners for all medical concerns on campus on behalf of program participants in need of attention.

Attend weekly case rounds as scheduled and actively participate.

Follow up on all Incident Reports involving medical concerns on campus.

Work closely with the participants to educate them on their current medical condition(s), diagnosis(es) and medication(s).

Work with the Case Managers to assist in developing a plan of care to address participants personal health care needs.

Consult and collaborate with other health care providers and specialists to set participant appointments or follow ups, as needed.

Provide wellness checks on participants regularly and evaluate and document progress.

Assist the participants care team with assessing and developing health interventions.

Attend ongoing training and courses to keep abreast of new developments in health care and case management.

Treat participants with empathy and respect and conduct oneself in a professional manner.

Comply with organizational guidelines and health care laws and regulations.

Conduct interviews, access resources to gather information for factual base on which to formulate a plan for participant in conjunction with Case Manager.

Demonstrate knowledge and understanding of participant health and social services presenting risks and apply appropriate risk stratification.

Convey knowledge of health and/or social service delivery model to participants.

Document accurately in established record system, daily.

Perform routine comprehensive, independent reassessment of participant status and progress toward achievement of plan goals, adjust in writing as appropriate.

Utilize existing community resources in providing care/services to meet goals.

Follow agency procedures to link with other SHELTER, Inc. services and staff supports.

Plan for, review with participant, and conduct appropriate closure of cases against specified criteria when resulting from program completion or voluntary exit.

In case of involuntary discharge/termination, or other adverse action, work with Shelter Supervisor and Program Manager to ensure all procedures are followed.

Participate in internal and external case conference/case coordination meetings.

Connect and maintain liaison to internal and external service resources.

Complete/attend trainings as required and to enhance skills.

Strategize with Shelter Supervisor around the support of outside vendors and interns providing care on campus.

Clean and sanitize office continually ensuring no cross-contamination from participant to participant.

Conduct scheduled and impromptu COVID-19 testing on site for all participants and staff as assigned.

Assist any outside care with providers that need the inclusion of addressing wounds, sprains, and fractures.

DATA & DOCUMENTATION

Follow established procedure for opening service file.

Meet data quality standards by reviewing discrepancies in data received, verifying accuracy, requesting clarification and advising supervisor of issues related to data.

Comply with data integrity and security policies.

Keep all relevant service data up-to-date in HMIS system and maintain case files in accordance with applicable guidelines, completing data entry immediately or no later than within 24 hours of service interaction.

Other duties as assigned.

EXPECTED PROFICIENCIES:

Knowledge of social service resource systems and self-help intervention strategies.

Basic knowledge of medical conditions and medications used in treatment.

Independently counsel populations of mental health, substance abuse, homeless individuals

Knowledge and skills in handling substance abuse and mental health issues.

Knowledge of public benefits and financial resources available in the community.

Ability to successfully develop relationships utilizing motivational interviewing techniques.

Crisis intervention and conflict resolution skills including use of motivational interviewing, harm reduction approach, and trauma-informed care.

Knowledge of family budgeting and money management.

Thoroughness and accuracy with data collection, entry and quality control in a web-based database.

Patience/tolerance and tact/diplomacy.

Clear/firm-yet-flexible boundaries, consistent energy level and positive demeanor.

Thoroughness and accuracy with data collection, entry and quality control in a web-based database.

Professionalism: high level of integrity and strong ethical values show capacity to maintain highest standards of confidentiality with all records, including organizational and individual information.

Strong oral/written communication and listening skills.

Self-motivated and accountable for work time and other agency resources.

Quality control: demonstrates accuracy and thoroughness, monitors own work to ensure quality and applies feedback to improve performance.

Well organized: able to effectively manage multiple assignments to meet project deadlines.

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