WHO WE ARE:

Are you interested in working for an organization whose mission it is to enable frail, underserved, and multicultural senior communities to live independently at home and in their communities, for as long as possible?

Bakersfield Program of All-Inclusive Care for the Elderly (PACE) is dedicated to providing its participants with comprehensive health and social supports that are proven to effectively manage chronic conditions and to reduce the risk for premature institutionalization. PACE staff are leaders in the “aging in place” industry and we have had the honor of serving Fresno, Bakersfield and Orange County seniors and their families/caregivers.

Job Summary

The Social Work Case Manager is responsible for providing direct social work case management services to participants.

Essential Job Functions

• Follow social work directives from interdisciplinary team (IDT) and meet with family members and other community members/agencies as needed.
• Coordinate ongoing family meetings, as needed.
• Provide ongoing case management and advocacy as required.
• In conjunction with the interdisciplinary team, coordinate discharge planning for participants returning home from hospital or nursing facility.
• Maintain current, written case management records, including ongoing documentation of services provided, and participants expressed wishes.
• Act as liaison between the participant and other agencies such as Department of Aging, Social Security Administration, Medicaid, etc.
• Participate in participant-related meetings with external agencies and conferences in the community as needed.
• Assist with ongoing government program financial eligibility applications for participants, including recertification as needed.
• Maintain confidentiality of participant information.
• Attend and participate in staff meetings, in-services, projects, and committees as assigned.
• Adhere to and support the center’s practices, procedures, and policies including assigned break times and attendance.
• Accept assigned duties in a cooperative manner; and perform all other related duties as assigned.
• Be flexible in schedule of hours worked.
• May require use of personal vehicle

Working Conditions and Physical Demands

The working conditions and physical demands described here are representative of those that

must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to access all areas of the center throughout the workday.
• Ability to lift up to 35 pounds occasionally, 15 pounds frequently, and 7 pounds constantly; required to obtain assistance of another qualified employee when attempting to lift or transfer objects over 25 pounds.
• Requires constant hand grasp and finger dexterity; frequent sitting, standing, walking and repetitive leg and arm movements, occasional bending, reaching forward and overhead; squatting and kneeling.
• Ability to communicate verbally with an excellent comprehension of the English language.
• Work is generally performed in an indoor, well-lighted, well-ventilated, heated, and airconditioned environment.

Knowledge, Skills, and Abilities

• Interest in the risk-based long-term care program to serve frail elderly in a community-based setting.
• Experience and thorough knowledge of social service principles and practices.
• Knowledge of psychosocial, behavioral, and family needs of the elderly population.
• Knowledge of financing mechanisms such as Medicare, Medicaid, and Prospective Payment Systems.
• Knowledge of the local and social service delivery systems and aging network.
• Proven ability to work in an interdisciplinary team.
• Ability to work effectively and harmoniously with the staff, the elderly, and providers of services, public, and private agencies.
• Energetic, dependable, resourceful, and flexible.
• Effective oral and written communication skills.
• Computer skills required.

Experience

• Preferred one (1) year of documented experience in working with a frail or elderly population required.
• Prefer experience in a community-based setting or geriatric program.

Education and Certification

• Bachelor’s degree in social work or related field required.
• Is medically cleared for communicable diseases and has all immunizations up-to-date before engaging in direct participant contact.