Community Transition Liaison
Community Transition Liaison – Hybrid Schedule – Hiring Bonus!
Seeking a full-time (37.5 hours/week) Community Transition Liaison. The Community Transition Liaison Program (CTLP) is an AGE state funded program that serves as an expansion to the previous Comprehensive Screening and Service Model (CSSM) Program. The goal of the program is to aid in safe and appropriate resident discharges from a skilled nursing facility (SNF) to the community setting, while working with residents, families, health care proxies (HCP), and skilled nursing facility (SNF) staff. The Liaison will act as the onsite point of contact for residents, families, health care proxies (HCP), and skilled nursing facility (SNF) staff related to transitions from SNF to the community and to aid in safe and appropriate resident discharge from SNF to community setting.
Duties include but are not limited to visiting with residents/family to increase awareness of services and introduce transition to the community as a potential option, completion of person-centered planning, conducting needs assessment, developing plan of care and guiding the CTLP Case Assistant in implementing plan of care by submitting referrals and completing appropriate applications (housing, public benefits), participating in interdisciplinary discharge meetings, and relationship building.
QUALIFICATIONS:
- Bachelor’s degree required.
- Field of degree in social work, psychology, counseling, human development, nursing, sociology, criminal justice, public health, public policy, or gerontology preferred.
- Bilingual skills and/or 2 years of experience in a related field may be substituted for education.
- Knowledge of long-term care, case management, discharge planning, community resources, programs, and benefits to help support an individual’s transition from an institutional to a community setting is preferred.
- Use of a reliable vehicle including active vehicle insurance with a current license to drive required.
ESSENTIAL ABILITIES:
- Demonstrate strong organizational, prioritization, and problem-solving skills.
- Ability to multitask, keep accurate records, have a strong attention to detail, document clearly, and communicate effectively verbally and in writing, all within a fast-paced environment.
- Ability to take initiative and work independently.
- Must have moderate physical ability. Ability to lift and carry objects weighing up to 20 pounds. Ability to climb stairs.
- Ability to work in an interdisciplinary model.
- Computer proficiency, including experience with Microsoft Office products (Word and Outlook).
- Ability to drive to provide home visits and attend meetings in the surrounding community
- A hiring bonus will be awarded in 2 parts, half at 120 Days, and half at 1 year of active employment. The bonus for this position is $1,000.
- No holidays or on-call
- Flexible schedules specifically designed for work/home balance
- Rich benefits package
- Pension and 4.4 weeks of annual earned vacation time
- 12 paid holidays
- Paid sick days
- Mileage reimbursement: .70 per mile
- Affordable health insurance
- Excellent work environment
Non-negotiable salary: $46,000.50 - $49,023.00
Please submit resume to salfaro@eswa.org
Come join our extraordinary team as our agency grows and expands and help make a difference in the lives of those that we serve!
AA/EOE, including disability/veteran