LCM/加强照护经理Lead Care Manager

Lead Care Manager Full time job 职位名称：LCM首席护理经理 汇报对象：ECM 总监 职位状态：全职 工作地点：现场办公 工作时间：周一至周五8:30AM至5:00PM 薪资：根据个人工作经验情况面议 概述 首席护理经理 (LCM) 将与会员合作，协调各服务提供商之间的综合护理。ECM 首席护理经理作为跨学科团队的一员，负责解决会员的身心健康、药物滥用、社会需求、口腔健康以及长期服务和支持等问题。所有服务均以面对面形式提供，并尽可能减少服务排除。首席护理经理的主要职责包括：拓展和联系新客户、进行全面评估、制定护理管理计划、协调护理、促进健康、提供过渡期护理服务、提供家庭支持以及协调社区和社会支持。首席护理经理职位要求具备卓越的客户服务技能和人际交往能力，并需运用循证实践方法，例如动机式访谈和伤害减少模式，以维持高质量的服务。该职位要求与服务于同一客户的内部项目以及外部合作伙伴和服务提供商建立牢固的关系，以确保客户获得最佳护理。 主要职责与责任 客户关怀 • 首次分配服务对象后，开展外联工作以建立良好关系，并在适用情况下与家庭成员沟通。 • 提供符合文化和语言习惯的沟通和信息，以吸引服务对象参与。 • 进行全面评估，确定其需求领域。 • 与服务对象合作，制定以人为本的个性化服务/治疗计划。 • 在服务对象家中和/或社区与其会面。如无法进行面对面会谈，则根据情况通过电话或远程医疗与服务对象进行沟通。 • 识别临床和非临床资源，以弥补服务对象在护理方面的不足。 • 组织服务对象的护理活动，并与其他团队成员合作制定护理计划。 • 确保服务对象拥有指定的初级保健医生 (PCP) 并持续获得护理。 • 通过跟进初级保健机构的生理和发育健康、心理健康、药物滥用治疗、口腔健康以及必要的社区和社会服务（包括必要的住房），确保所有服务提供者之间的护理整合。 • 为客户提供预约提醒，协调交通，陪同客户参加重要预约，并识别和解决客户参与治疗的障碍。 • 支持客户培养识别和获取资源以帮助他们管理自身状况的技能。 • 为客户提供过渡护理服务，帮助他们从一个机构或护理级别过渡到另一个机构或级别，包括从医院、机构和其他急性护理机构出院到家庭或社区机构。 • 与家庭成员进行适当程度的沟通，以评估服务并参与治疗。 文档记录 • 协助填写入院文件。 • 完成初始评估和每半年一次的复评。 • 完成客户护理计划并根据需要进行修订。 • 使用相应的电子健康记录 (EHR) 系统，按照指示妥善记录个案管理和/或其他活动。 • 在服务后 24 小时内录入个案记录。 其他 • 与其他服务提供者协作，确保提供适当的治疗/支持。 • 及时将客户的需求和偏好传达给客户的多学科护理团队。 所有机构员工的共同职责 • 始终维护安全的工作环境并遵守保密原则。 • 在确定、评估、研究和解决问题时，积极主动、富有创造力且灵活应变。 • 组织并优先处理多项活动，以满足所有内外部截止日期。 • 保持专业的举止，为机构树立良好的形象。 • 尊重他人，待人礼貌。 • 能够在强调团队合作的工作环境中茁壮成长。 • 及时回应所有沟通事宜。 • 在最少的监督下独立工作。 • 完成分配的其他任务。 资格要求 • 社会科学或相关专业的学士学位，或两年以上服务于无家可归人群的工作经验。 • 1-2年服务于无家可归者和/或低收入及混合收入人群的工作经验，并具备儿童福利、家庭工作和药物滥用方面的经验。 • 了解低收入和无家可归者及其具体需求。 • 掌握危机预防、干预、目标设定和解决技巧，并能根据具体情况和个人情况运用相应的技巧。 • 精通Microsoft Office办公软件，包括Microsoft Word和Excel。 • 优秀的客户服务、沟通和问题解决能力。 • 优秀的组织能力。 • 能够在截止日期前高效工作并同时处理多项任务。 • 能够与社区建立关系和联盟。 • 能够建立伙伴关系和良好关系。 联系方式 有意者请联系：Amy Li (HR) 电话：(626) 716-9745 (短信） 邮箱：[email protected] SUMMARY The Lead Care Manager (LCM) will work with members to coordinate comprehensive care among various service providers. The ECM LCM works as part of an interdisciplinary team to address the member’s physical and mental health, substance use, social needs, oral health, and long-term services and supports. All services are provided in person, with minimal exclusion. The Lead Care Manager primary responsibility requires outreach and engagement of new clients, comprehensive assessment, development of care management plan, coordination of care, health promotion, transitional care services, family supports, and coordination of community and social supports. The Lead Care Manager position requires excellent customer services skills, people skills, and is expected to use Evidence Based Practices, such as Motivational Interviewing and Harm Reduction Model to maintain high quality services. This person is required to build strong relationships with internal programs serving the same clients and our external partners and service providers to ensure clients receive the best care possible. ESSENTIAL DUTIES & RESPONSIBILITIES ：Client Care • Conduct outreach when first assigned a member to establish rapport, including family engagement when applicable. • Provide culturally and linguistically appropriate communication and information to engage members. • Conduct a comprehensive assessment to determine areas of need. • Collaborate with clients on developing a person-centered, individualized service/treatment plan. • Meet with clients in their homes and/or community. When an in-person session is not possible, meet with client on the phone or via telehealth as appropriate. • Identify clinical and non-clinical resources to address clients’ gaps in care. • Organize clients’ care activities and collaborate with other members of the team regarding the care plan. • Ensure that client has an assigned PCP and accesses care consistently. • Ensure integrated care among all service providers by following up with primary care physical and developmental health, mental health, SUD treatment, Oral health, and necessary community-based and social services, including housing as needed. • Provide appointment reminders to clients, coordinate transportation, accompany to critical appointments, and identify and address barriers to engagement in treatment. • Support members in developing skills to identify and access resources to assist in managing their conditions. • Support clients in transitional care services from one setting or level of care to another, including discharges from hospitals, institutions, and other acute care facilities to home or community-based settings. • Engages with the family members to the appropriate extent to assess services and involve in treatment. Documentation • Facilitate intake paperwork. • Complete initial assessment and bi-annual reassessment. • Complete Client Care Plan and revise as necessary. • Maintain proper records on case management and/or other activities as instructed utilizing the appropriate Electronic Health Record (EHR). • Enter case notes within 24 hours of service. Other • Work collaboratively with other providers to ensure appropriate levels of treatment/support. • Communicate clients’ needs and preferences in a timely manner to the clients’ multi-disciplinary care team. RESPONSIBILITIES COMMON TO ALL AGENCY EMPLOYEES • Always maintain a safe work environment and confidentiality. • Be proactive, creative, and flexible in determining, evaluating, researching, and resolving issues. • Organize and prioritize multiple activities to meet all external and internal deadlines. • Maintain professional demeanor that reflects positively on the agency. • Demonstrate respect and courtesy toward others. • Able to thrive in a work environment emphasizing teamwork and collaboration. • Respond in a timely manner in all aspects of communication. • Work with minimum supervision. • Perform other duties as assigned. QUALIFICATIONS • Bachelor’s degree in social sciences or related OR 2 years of experience working with the homeless population. • 1-2 years of experience working with homeless and / or low and mixed- income populations in addition to experience in child welfare, family work, and substance abuse. • Understand low-income and homeless individuals and their specific needs. • Knowledge of crisis prevention, intervention, goal setting, and resolution techniques should be able to match sib techniques to circumstances and individuals. • Proficient skills in Microsoft Office, including Microsoft Word and Excel. • Excellent customer service, communication and problem-solving skills. • High quality organizational skills. • The ability to work well under deadlines and to multitask. • The ability to build relationships and coalitions with the community. • The ability to build partnerships and good relationships with providers and clients. • Excellent verbal and written communication skills. • Excellent critical thinking and problem-solving skills. Monday - Friday 8:30am - 5:00pm (30mins lunch break) Please send CV to ：[email protected] Contact：6267169745 （SMS） HR Amy Li