Bilingual GSSC SCO Tufts

Job Description

Job Description

POSITION SUMMARY:

The Geriatric Support Services Coordinator (GSSC) is the care manager assigned to work with SCO enrollees and is a member of the Primary Care Team (PCT). With the SCO Program Coordinator, the GSSC is responsible to coordinate and providing community social services to SCO enrollees in accordance with the SCO’s policies, procedures, and practices.

PRIMARY RESPONSIBILITIES:

1. As a member of the Primary Care team (PCT), participate in Initial and Ongoing Assessments of the health and functional status of enrollees and develop community-based care plans and related service packages necessary to improve or maintain an enrollee’s health and functioning

Arrange, coordinate, and authorize the provision of appropriate long-term care and social support services for enrollees (with the agreement of the PCT and in accordance with requirements set forth by the SCO). These may include, but are not limited to: ADL and IADL assist; Housing, Home-delivered Meals; Transportation.

1. Monitor the appropriate provision and functional outcomes of community long-term care services that have been authorized by the PCT.
2. Track enrollee transfers and adjust service plan as deemed appropriate by the PCT and in accordance with requirements set forth by the SCO.
3. Provide care management services via the telephone as requested by the SCO RN.
4. Prepare documentation for enrollee files, agency database, and for the SCO Coordinator to submit to the SCO RN.
5. Perform all services in accordance with state and federal law and written SCO management protocols, including timely entry of all information required to be included in Centralized Enrollee Records (CER).
6. Maintain care management documentation as specified in the SCO care management protocols.
7. Report suspected Fraud, Waste, and Abuse (FW&A) as required by CBES FW&A policy.
8. Protect Consumers’ Personal Health Information (PHI) and report any suspected security breaches.
9. Respond promptly to enrollee service requests.
10. Attend and participate in PCT, agency, and departmental meetings and trainings as required.
11. Other duties as assigned.

QUALIFICATIONS:

1. Bachelor’s Degree and two years of professional experience in case management, services coordination, outreach, and/or advocacy with persons over the age of 65 preferred.
2. Ability to assess clients and their needs and knowledge of the community-based service network.
3. Excellent interpersonal and problem-solving skills required.
4. Ability to work with a diverse population and within a multi-disciplinary team.
5. Access to a car is required.
6. Knowledge of other languages preferred.
7. Ability to walk stairs.
8. Ability to carry a laptop and documents required to complete a home visit.
9. Required Languages: Russian, Mandarin, Cantonese, or Chinese)