Community Health Care Manager in Philadelphia, PA at Public Health Management Corporation

Date Posted: 8/9/2020

Job Snapshot

Job Description

Location: South-Central PA; Frequent travel required

The Community Health Care Manager (Care Manager) will provide home visiting services to families with newly diagnosed children through HPC's Community to Home Program. Services will focus on families residing in the South-Central rural counties of Pennsylvania which include: Adams, Blair, Franklin, Fulton, Huntingdon, Juniata, Mifflin and Perry. The Care Manager, whom should reside in one of these counties, will provide individualized health education, promote health literacy and provide medical and social system navigation services for individuals and families living in the region. The Care Manager maintains contact with clients via in-person visits, email and phone and will be responsible for conducting assessments and health screenings, observing behavioral health, communicating with clients about their child's health and making referrals to community agencies and organizations. Through referrals from health systems and community organizations, the Care Manager assesses needs, coordinates care at home, in the community or school settings, and supports other needs within the home. The Care Manager collaborates with health care, social service, and other agencies to function as an advocate and liaison between families, promoting healthy communication. This position will have contact with enrolled families and the corresponding medical and social systems. This position will require travel throughout the South-Central Pennsylvania, a driver’s license and access to a reliable vehicle with current registration, and current auto insurance. Some evening and weekend work, as well as some overnight travel required.

Responsibilities:

  • Must reside in a South-Central rural county
  • Prepares and maintain records, reports and/or test data on participating children and families
  • Maintains contact with participating clients via phone, email, mail, home visits, videoconference; as appropriate
  • Work as a part of the CTH team and has ability to function in self-paced structured environment
  • Attends all required meetings and trainings, including active participation in outreach presentations and meetings
  • Documents all client contacts using required written forms: assessment forms, progress notes, referral forms, discharge and transition plans
  • Communicates formally on a weekly basis with Program Manager
  • Assists in the development of new approaches to improve program delivery, content, and/or evaluation implementation
  • Attends local and regional meetings and trainings relevant to Community Health Work
  • Attends the bi-weekly CTH team meetings in-person one a month; attends other team meetings via phone/videoconference

Care Management Activities:

  • Carries a caseload of approximately 20 cases of newly diagnosed children
  • Conducts home visits to develop individual and community based plans of care, provide health education and promotion services, and provide follow-up visits with families
  • Establishes and maintains linkages with community health, social service, education and legal service agencies, and other support services
  • Provides health education to families and relevant social supports  
  • Assists participating families to access appropriate health and social services
  • Develops service plans that support both program and family goals
  • Meets participants in various locations, including doctor's office, home, schools and community locations
  • Serves as an advocate and stabilizes children and families with emphasizes on social services
  • Participates with Program Manager in coordinating referral and services for high risk children and families
  • Maintains accurate records and observes HIPAA requirements; generates data and reports appropriately; evaluates the effectiveness of service
  • Equips families with emergency preparedness response strategies through co-development of individualized preparedness plans
  • Develops formal communication protocols for individual families and health care professionals working directly with the child; doctors, specialists, nurses, school nurses, home care professionals, MCOs/insurance companies

Skills:

  • Must demonstrate strong organization, time management and problem-solving skills
  • Ability to structure in-home office and be self-motivated
  • Ability to deliver effective individual health education
  • Advocate for client and community strengths and needs
  • Ability to assess and triage social services quickly
  • Advanced proficiency in Microsoft office suite and various web-based platforms with an ability to learn new software, as needed
  • Must clear child abuse, criminal history check and FBI clearance
  • Must travel throughout South-Central Pennsylvania
  • Ability to work both independently and in a team environment to meet objectives with minimal supervision
  • Ability to acquire information about new systems, organizations and practices
  • Motivational interviewing techniques
  • Bi-lingual preferred but not mandatory

Experience:

  • Demonstrated experience in issues related to home-visiting, children with special health care needs, child development, and technology used to compensate for the loss or diminishment of a vital organ
  • Experience working with diverse populations and low-income individuals
  • Experience with case management documentation
  • At least two years' experience in community health and home visiting
  • Experience providing workshops and trainings to other professionals
  • Experience successfully coordinating community events with multiple stakeholders
  • Experience in data collection/entry and evaluation monitoring

Education Requirement:

  • Bachelor's degree in social work or related field preferred; or Associate Degree and two years relevant experience
  • If no degree, 5 years relevant experience

Salary:

  • Commensurate with education and experience