Hospital Liaison

Home and Community Based Services (HCBS) Hospital Liaison

Do you find joy in helping others? As the Home and Community Based Services (HCBS) Hospital Liaison, you will work collaboratively with Melrose Wakefield Hospital's case management team to transition older adults from the hospital setting back into the community.

This is a full-time, non-exempt (35 hour/week) position. We offer a hybrid remote schedule and the option of a flexible 4-day work week. Our office is located in Malden, MA with ample free parking. You will be working at Melrose Wakefield Hospital as well.

Compensation: Starting annual salary is $52,500. Being multi-lingual is not a requirement for this role, but we recognize it as an asset and offer an additional 6% bilingual designation. Enjoy benefits that start as of day 1 of employment and our generous paid time off package.

If you want to support patients in connecting to Home and Community Based services with a goal of preventing post-acute institutional care, then we need you.

With a refreshing culture that is supportive, collaborative, and encouraging of diverse perspectives and backgrounds and a satisfying balance between your work and personal life, why not join the Mystic Valley Elder Services' Team!

Working at MVES means:

• A focus on innovation with a team recognized for developing and implementing innovative programs and novel solutions
• Encouragement of your development through opportunities to get involved, use your voice, and gain new knowledge and skills
• Competitive salaries
• Tufts Medical insurance, Delta Dental and VSP Vision insurance effective 1st day of employment
• 403b Retirement Plan with agency contribution after 2 years of employment
• 3 weeks accrued Vacation time
• 3 weeks accrued Sick time
• 13 Paid Holidays
• 30 personal hours

What you'll be Responsible for:

Essential functions of the position are below. Additional duties may be assigned as required.

• Support the hospital's efforts in connecting individuals to Home and Community Based programs and services that support a discharge to the community.
• Coordinate with hospital staff to ensure a successful transition to home in order to prevent admission to post-acute institutional care.
• Participate in Hospital Care Management team meetings, daily huddles, interdisciplinary rounds, case conferences and other relevant meetings with hospital care management staff.
• Outreach and connect with patient and family/caregivers at the bedside to initiate person-centered planning.
• Assess the patient's functional, health and income status to determine eligibility and appropriateness for community long term care services or programs utilizing a standardized assessment tool.
• Identify patients who are enrolled in care and service programs such as ASAP, SCO, and VNA to ensure effective care planning and service coordination for a transition home.
• Arrange a face to face visit post discharge to assess the home environment and social supports.
• Assist with scheduling a follow up medical appointment and ensure transportation or hands on assistance is available if needed.
• Coordinate with appropriate medical staff or pharmacy around medication issues and proper medication management by patient.
• Review "red flags" and when to contact PCP or VNA.
• Report to the care team any identified issues in the home that may prevent the patient from remaining in the community.
• Participate in required orientation and training including ASAP training, hospital orientation and EMR training.
• Ensure timely documentation, information exchange, coordination, and integration of care.
• Provide information and trainings for hospital care management staff regarding HCBS alternatives to instructional care as indicated.
• Compile and submit required statistics and reports.

Qualifications:

• Bachelor's degree in social work, human services or related with case management and experience with the older adult population preferred. Associates degree with significant relevant work experience can be submitted for portion of degree.
• Two years of experience in individual needs assessment and care planning, with a focus on eldercare issues and resources.
• Annual flu shot
• Documentation of a primary series of WHO approved Covid-19 vaccine
• Required proof of immunizations: negative TB test (has been done within 1 year), MMR (measles, mumps, rubella), Chicken Pox; OR consent to have titer drawn for above immunizations.
• Ability to be a self-starter, work independently, and demonstrate flexibility in responding to consumer needs.
• Ability to be flexible and be able to adapt to, and work effectively in, the culture of a medical environment
• Strong interpersonal, organizational, time management and customer service skills.
• Excellent written and verbal communication skills.
• Excellent problem-solving skills.
• Strong interviewing and assessment skills.
• Ability to prioritize.
• Ability to transition among tasks.
• Ability to make sound decisions.
• Ability to take initiative.
• Computer skills: Proficient with MS Office Suite, and entering narrative and other data into a database. Working knowledge of Excel. Ability to use the Internet to conduct information searches.
• Private transportation.
• Experience in a health care setting preferred.

Mystic Valley Elder Services is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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