HOURS OF AVAILABILITY MUST BE BETWEEN 8am - 6pm, Monday - Friday, COMMUNITY VISITS REQUIRED

Status: PRN

Work Location: Remote except for when conducting client visits or participating in required in-person meetings or training sessions.

Job Summary:
Responsible for working to transition Nursing Facility residents (Home First) and Home Choice clients back to community settings by utilizing specialized community resources, advocacy, and assessment skills while ensuring the needs of consumers and caregivers are
met.

Essential Functions:
• Completing person-centered assessments in a Nursing Facility to provide long-term care options to clients and their care givers on potential programs and resources which can assist the client to meet his/her needs in the community.
• Educating and assisting individuals and his/her legal guardians, authorized representatives, and/or caregivers on program eligibility, participation, expectations, rights, and resources.
• Developing relationships with hospital discharge planners, PCPs, Nursing Facilities and social workers
• Identifying potential clients for transition to a community setting.
• Identifying services required for successful transition to home and facilitates referrals to COA.
• Providing client with information on community services and agency services which will address their needs and make the appropriate referrals on behalf of the client.
• Working with Nursing Facilities and Caregivers to promote return to the community following hospitalization/NF stays when appropriate.

Required Education, Licensing & Certifications:
• Ohio Licensed Social Worker or Registered Nurse licensure in good standing with the credentialing board.
Experience:
• At least one year of experience in medical social work and/or geriatrics.

Skills & Abilities:
• Understanding of the health care system and its components including sites of care, delivery models, and the roles of various providers and health care professionals
• Ability to develop and maintain positive working relationships with clients and their caregivers.
• A good working knowledge and understanding of issues related to the older adult population.
• Ability to manage a caseload and complete Nursing Facility visits and phone contacts both as required and as needed to assess program eligibility and ongoing service eligibility for identified/continued needs.
• Good oral and written communication skills
• A valid driver’s license and reliable transportation for travel within Butler, Clermont, Clinton, Hamilton, and Warren Counties.
• Proficient computer skills including the Windows operating systems, MS Word, MS Excel, data entry and the ability to learn new software applications as needed