Job Description

The Community Case Manager/Options Counselor provides Community Options Counseling services to nursing facility residents, assessing their potential for transitioning back to community living. This role involves monthly visits to Skilled Nursing Facilities (SNFs) and conducting face-to-face meetings with residents to facilitate successful community integration. The Options Counselor collaborates closely with the Transition Coordinator to ensure comprehensive support for participants.

Essential Duties and Responsibilities:

Counseling and Assessmen t:

• Conduct face-to-face counseling sessions with residents to evaluate their readiness for community transition.
• Assess residents' physical, emotional, and social needs to determine suitability for community living.

Facility Engagement:

• Make monthly visits to Skilled Nursing Facilities to engage with residents and facility staff.
• Work directly with residents, families, physicians, service providers, and discharge nurses to develop comprehensive care plans.

Resource Coordination:

• Provide information on community-based alternatives, including housing, medical providers, transportation, and support services.
• Establish connections between residents and community agencies, housing programs, and other necessary resources.

Documentation:

• Maintain detailed records of counseling sessions and assessments.
• Complete and submit required documentation and referral forms within specified timeframes.

Collaboration:

• Work closely with the Transition Coordinator to ensure cohesive and comprehensive support for participants.
• Communicate regularly with state agencies and nursing facilities to facilitate seamless service delivery.

Required Qualifications:

Education and Experience:

• Education: At least four years of college, vocational training, certification, or equivalent in a related field (health, nursing, or human services). Life and work experience with long-term care programs, home and community-based services, or programs serving seniors and/or persons with disabilities may substitute.
• Desired: Bachelor’s degree in gerontology, social work, psychology, or a related field.

Experience:

• Serving seniors with mental, physical, or functional impairments.
• Understanding of Medicaid and/or Medicare benefits.
• Experience in inpatient facility discharge planning and care plan development.

Skills and Knowledge:

• Strong assessment and counseling skills.
• Excellent documentation and communication abilities.
• Ability to handle moderate to high levels of stress.
• Understanding of Medicaid eligibility and nursing facility operations.
• Familiarity with discharge planning processes.

Physical and Emotional Demands:

Physical:

• Ability to move and unload small to medium-sized items for home setup (e.g., microwave, chairs).
• Move small personal items into participants' new residences.
• Remain seated and operate computer/office equipment for extended periods.

Emotional:

• Manage moderate to high stress during consumer transitions and high call volumes.
• Adapt communication and behavioral styles to meet diverse participant needs.

Work Environment:

• Travel: Regular travel within the St. Louis metropolitan area to nursing facilities.
• Setting: Combination of office-based and field-based work.
• Schedule: Standard business hours with some flexibility to accommodate participant and facility schedules.
• Requirements: Must maintain appropriate licensure and background checks per organizational and legal standards.

Physical and Emotional Demands:

• Physical:
• Ability to move and unload small to medium-sized items for home setup (e.g., microwave, chairs).
• Move small personal items into participants' new residences.
• Remain seated and operate computer/office equipment for extended periods.
• Emotional:
• Manage moderate to high stress during consumer transitions and high call volumes.
• Adapt communication and behavioral styles to meet diverse participant needs.

Work Environment:

• Travel: Regular travel within the St. Louis metropolitan area to nursing facilities.
• Setting: Combination of office-based and field-based work.
• Schedule: Standard business hours with some flexibility to accommodate participant and facility schedules.
• Requirements: Must maintain appropriate licensure and background checks as per organizational and legal standards.

Physical and Emotional Demands:

• Physical:
• Ability to move and unload small to medium-sized items for home setup (e.g., microwave, chairs).
• Move small personal items into participants' new residences.
• Remain seated and operate computer/office equipment for extended periods.
• Emotional:
• Manage moderate to high stress during consumer transitions and high call volumes.
• Adapt communication and behavioral styles to meet diverse participant needs.

Work Environment:

• Travel: Regular travel within the St. Louis metropolitan area to nursing facilities.
• Setting: Combination of office-based and field-based work.
• Schedule: Standard business hours with some flexibility to accommodate participant and facility schedules.
• Requirements: Must maintain appropriate licensure and background checks as per organizational and legal standards.

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