Job Description
AgeOptions is recognized nationally as a leader in developing and helping to deliver innovative community-based resources and options to older populations in transition and through our network of community agencies, who serves over 200,000 people annually.
To learn more about what we do, please visit our website at: AgeOptions (www.ageoptions.org)
What is the H.O.P.E.
Program?
H.O.P.E.
by AgeOptions is a Nursing Home Transition program.
We assist individuals, 18 years and older, who have been living in a nursing home to transition back to the community.
Through integrated teams of professionals in the social services and healthcare arena, we help individuals successfully return to the community.
Our teams provide life skill building, physical and emotional services and supports, advocacy and assistance, and on-going case management to ensure a safe and successful transition from Nursing Home to the Community.
We work with individuals (18+) throughout Cook County who have a multitude of physical disabilities, co-morbid diagnoses, behavioral health diagnoses, substance use histories and histories of being unhoused.
In a nutshell, you will be part of the interdisciplinary team that assists individuals transitioning from a nursing home back to community living with supportive services.
Creating and developing person centered care plans, helping with the coordination of activities to support their move into the community and following up to help them adjust afterward.
This is a "Hybrid/Field/Remote" role (includes office, field and remote work which can be your home) you must be able to work in the field 2-3 days a week (travel in the greater Chicago area and surrounding suburbs).
Bring your experience and passion to support the independence and well-being of our clients!
AgeOptions offers a competitive salary (including a $2,000 sign-on bonus for active RN hires) and benefits package
What you will be doing: Conduct in-person transition management care management activities including but not limited to comprehensive multi-disciplinary assessment/evaluation that identifies and prioritizes goals, strengths, weaknesses, issues, risks and barriers to care following all required guidelines and documentation.
Collaborate with the member's interdisciplinary team to identify any risks, discuss appropriate care planning and troubleshoot any challenges while working with relevant agencies involved.
Continually review and monitor member's complete medical files and pertinent documentation from their current residential facility for input into the assessment/evaluation and Service Plan Development processes.
Develop a comprehensive, person-centered service plan for each resident and monitor and update service plan according to program guidelines.
Facilitate discharge planning and transition to community with client, nursing facility staff, health plan, and other identified supports.
Provide comprehensive care management after the client transitions into the community, including coordinating benefits, in-home services and community resources; schedules medical appointments; and advocates for clients as needed.
Collaborate with partner agencies to facilitate all aspects of the transition and assimilation to independent living.
Follow all program standards and procedures.
Experience and Skills What knowledge and experience are we looking for: Bachelor's degree in nursing and with current licensure to work in IL At least 2 years' experience in providing social services, hospital, rehab facility, assisted living communities or other similar healthcare environments.
Experience working directly with clients with severe mental health conditions, drug/alcohol abuse and/or complicated physical illness preferred.
Excellent written and oral communication skills needed, with demonstrated ability to engage clients Computer skills required: Microsoft Office Suite; ability to learn proprietary program databases Knowledge of community supportive services Sensitivity to cultural diversity Ability to work with people who have multi-faceted needs The position regularly works in the field and must travel throughout the greater Chicagoland area (city, suburbs and collar suburbs).
Daily access to a reliable transportation is a requirement Experience with Community Care Program (CCP) or other care management program, preferred Experience with Colbert and/or Williams consent decrees, preferred
If you are a nursing professional with an outgoing and caring demeanor and at a point to make a move seeking a more flexible working environment, here's where you can have an impact!
AgeOptions is an Equal Opportunity Employer where diversity is celebrated, and we are committed to creating an inclusive environment for all!
Job Benefits
The starting salary range is $68,000-$80,000 annually; based upon an individual's experience, education and licensing and considering our internal equity.
In addition to your annual salary AgeOptions makes a 5% contribution to your 403(b) whether your contribute or not!!
This is a full time role and includes ability to participate in our medical, dental and vision plans