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.
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 - 18 months ago