JOB DESCRIPTION

• Position: ALWP Clinical Care Coordinator
• Pay Range: $85,000 - $100,000
• Reporting To: Director of ALW Services/ALWP Nurse Manager
• Work Type: Remote/In the Field

POSITION SUMMARY

The RN Clinical Care Coordinator is responsible for the clinical care coordination of ALWP clients under the Care Coordination Agency (CCA). Care coordination includes identifying, organizing, coordinating, and monitoring services needed by a recipient. The RN Care Coordinator assists waiver recipients in gaining access to waiver services, state plan services and other community resources. The RN Clinical Care Coordinator also acts as the clinical resource for the CCT Program.

QUALIFICATIONS

1. Must have a current, unsuspended, un-revoked license to practice as a Registered Nurse in California.
2. Knowledge of The State of California Assisted Living Waiver Care Coordination Agency Provider Handbook and RCFE Provider Handbook and the clinical requirement of the CCT and ALWP transition process.
3. Knowledge of current Nursing Practice Act. The Nursing Practice Act (NPA) is the body of California law that mandates the Board to set out the scope of practice and responsibilities for RNs. The NPA is located in the California Business and Professions Code starting with Section 2700. Regulations which specify the implementation of the law appear in the California Code of Regulations.
4. Possesses current CPR certification.
5. Minimum two (2) years’ experience in a home health organization, primary care clinic, or a health facility. One (1) year experience in healthcare quality management, preferred.
6. Current and satisfactory report on pre-employment physical examination including TB Screening Test or chest X-ray as required by Agency policies and procedures. Must be free from signs of infection and illness.
7. Exercises excellent judgment and possesses knowledge of current nursing practices, with demonstrated exemplary clinical, analytical, and documentation skills.
8. Possesses good written and verbal communication skills. Fluent in English.
9. Must be a licensed driver with an automobile that is insured and is in good working order, in accordance with state and/or organizational requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The following is a representation of the major duties and responsibilities of this position. The agency will make reasonable accommodations to allow otherwise qualified applicants with disabilities to perform essential functions.

1. Responsible for the proper completion of all clinical documents required for the State Waiver Program Application as per ALWP and Agency policy.
2. Conducts assessments using the ALW Assessment Tool, determining each client’s level of care (i.e. tier).
3. Develops Individualized Service Plans (ISPs) using the ALW ISP Form and modifies the ISP as needed.
4. Monitors service delivery, adhering to the prescribed schedule of client contact. Conducts face-to-face visits with clients monthly, and as needed.
5. Maintains proper charting, progress notes and case records for each enrolled client.
6. Manages complaints from clients, families or friends.
7. Reports all signs of abuse or neglect to DHCS and the Ombudsman (if abuse or neglect occurs in an RCFE) or DHCS and APS (if abuse or neglect occurs in PH).
8. Responsible for attending Case Conferences with RCFE’s monthly, or as needed. These meetings are held at the Residential Care Facility.
9. Evaluates ISP effectiveness through observation of Client’s physical condition and behavior, signs and symptoms of illness, reactions to treatment, and through communication with the Client and health team members.
10. Reviews Significant Incident Reports (SIRs) with the client and RCFE staff, as necessary.
11. Serves as the clinical support for the CCA Office Coordinators.
12. Participates in Education, Training and Quality Improvement Activities for the ALWP. Assists the Agency in maintaining compliance with Federal, State, Local and HIPAA Regulations or Joint Commission Standards.
13. Establishes and maintains good relationships with RCFE, SNFs and other vendors.
14. Regularly self-assesses nursing skills and educational needs to meet the nursing care requirements of patients assigned for care.
15. Significant driving may be required throughout the Los Angeles, San Bernardino, San Diego, Ventura and Fresno County.
16. Maintains a comfortable work environment for all employees.
17. Maintains proper timekeeping.
18. Follows policies and procedures as per Employee Handbook.
19. Maintains all required credentials up-to-date.
20. Reports fraud and abuse.
21. Knowledge of mandated reporting.
22. Conducts timely recording and/or documentation of all client contact.
23. Attends department meetings (in person, by phone or by web).
24. Attends all state mandated in-service trainings.
25. Possesses familiarity with Title 22.