Under the supervision of the Care Coordination/Case Management Supervisor and/or the Regional Program Director,, will be responsible for enrolling and providing care coordination services to families with children 0-5 years who are participating in Healthy Development Services program funded by First 5, tracking family progress from intake to discharge and/or transition to another program.
- 70% of families waitlisted to initiate treatment are enrolled in PS&E or other services while waiting for specific services. -
Care Coordination intake form is completed 85 % (at minimum) for families who continue on to developmental/speech and language services.
- Closes 100% of cases according to protocols.
- CM appointments are scheduled (70% at minimum) for families that stay with the Program
- Communicates efficiently with all appropriate individuals and/or agency representatives according to each family’s needs, including but not limited to maintaining ongoing communication with families and relevant personnel from other agencies; assisting in obtaining appointments internally and externally; sharing information with other service providers as needed; speaking with data; acting as primary liaison with clinic and external site/agency providers; and understanding the importance of the evaluation process and ensuring data accurately represents services rendered and the child’s progress.
- Completes accurate and timely documentation for all patients under Care Coordination/Case management. This includes but is not limited to organizing caseload documentation according to protocol; maintaining working files organized; reviewing and tracking cases efficiently; maintaining case status and case disposition current; maintaining referral documentation; making appropriate registration and dashboard notes; responding to audits; and complying with Quality Assurance protocols.
- Completes Dev. Pre & Post (Parental Knowledge/Skills) and enters data in Portal within 48 hours for 85% (at minimum) of cases completing minimum required treatment.
- Develop a care plan in collaboration with the family for 85%(at minimum) of (level 2 and level 3) cases that need ongoing services. (Note A service plan should be completed for all level 1 cases, i.e. parent support and empowerment classes; hearing/vision screening, dev. re-screening; etc.)
- Ensures initial S/L treatment session is scheduled for 80% of the cases (at minimum) pending for treatment during weekly reviews.
- Ensures prompt scheduling of LDS and S/L consult within 48 hours of DA for 80% of cases (at minimum) needing S/L services.
- Ensures that children who need treatment are scheduled for initial treatment appointment within 2 weeks of the developmental assessment, 70% of the time at minimum.
- Keeps an organized system of handouts, and resource lists available to parents as needed by each individual case as monitored by supervisor.
- Monitors open cases daily and contacts the family within a week of ASQ completion to ensure a DA appointment has been scheduled (70% of cases at minimum) as monitored by supervisor’s weekly review of Portal screen of open cases.
- Obtain/and or verify completion of Patient History form for 85% (at minimum) of cases who have been assessed.
- Perform other related duties as assigned by management.
- Provide prompt feedback to physicians, partners and other referral sources about status of child’s services for 80% (at minimum) of active cases.
- Responds to alerts and follows up with required action within a week of notice (85% at minimum) from Data Manager or Supervisor for required cases.
- Tracks cases to coordinate Pre and Post-test with reassessment as appropriate for each case. Checks the R/A report to see if discharged with gains, updates Case disposition appropriately.
- Tracks cases to ensure Pre and Post tests have been completed and entered in the system for Speech and Language Services.
- Understands care coordination principles and successfully executes all Care Coordination activities, including but not limited to screening for HDS eligibility; explaining recommended services; assessing child and family needs; ensuring there is no duplication or suplantation; enrolling families in care coordination; developing a care plan; processing incoming and outgoing referrals according to protocol; reassessing needs; following up on cases; tracking referrals and care progress; entering Pre and Post-test data; ensuring all relevant case information is collected from parent; using Portal to keep track of coordinated services; participating in meetings as required by program needs and each child/family’s needs.
- Understands the importance of the role of care coordination and case management in HDS and is able to execute the goals of care coordination, including but not limited to engaging/connecting with families; preventing high incidence of loss to follow-up; empowering parents; monitoring, tracking and documenting cases.
- Bachelors Degree in Child Development, Social Work, Psychology, Public Health, or other related field required. Applicants with prior experience in Case Management (minimum of 3 years) at County or State Agencies serving young children and their families and/or coursework work in Child Development (50 units) will also be considered.
- Must have basic knowledge about child development and developmental milestones.
- Must possess valid California driver’s license and appropriate auto insurance as required by law.
- Ability to multi-task.
- Basic understanding of evaluation and outcomes.
- English/Spanish required.
- Excellent customer service skills and ability to explain HDS program services
- Excellent negotiating and communication skills to effectively engage families in range of services.
- Excellent problem-solving skills and professional judgment in assisting families overcome barriers to care.
- Is resourceful (knows community resources).
- Minimum 3 years full-time work experience in the provision of care coordination and case management for young children age (0-5) and their families highly desirable.
- Must demonstrate ability to work with a multi-disciplinary team.
- Must demonstrate cultural sensitivity.
- Must have basic knowledge about developmental milestones and risk factors that may affect development.
- Must have computer skills.
- Must keep data up to date, and be able to interpret it, identify discrepancies and correct same
- Must know principles of care coordination and case management.
- Must possess excellent writing skills.
Family Health Centers of San Diego (FHCSD) is an organization rich in history and tradition. The small building located at 1809 National...