Case Manager

About the Role

Case Managers make home visits to screen persons referred to Meals on Wheels Pus, Inc. for services and conduct update visits for current clients. They handle special visits as required, follow notification and reporting procedures annually, and work under the direct supervision of the Assistant Director.

Responsibilities

• Conduct initial home visits within 10 calendar days for persons referred for services within assigned caseload.
• Ensure services are initiated within 10 calendar days from the effective date of Texas Health and Human Services (HHS) referrals, including Managed Care clients from Amerigroup and Superior.
• Complete all required paperwork, including:
  • Annual Nutritional Risk Assessment for clients age 60 and older (excluding Managed Care clients).
  • Annual form measuring Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) for clients age 60 and older (excluding Title XX or Managed Care clients).
• Provide clients with annual information on their rights, responsibilities, complaint procedures, privacy of confidential information, and abuse, neglect, and exploitation.
• Respect the confidentiality, rights, and privacy of all clients.
• Follow up when clients are not home to receive meals after two consecutive failed delivery attempts.
• Determine if a referral is of an emergency nature and contact individuals within 24 hours or by the next workday.
• Maintain awareness of deadlines impacting clients and coordinate activities to ensure deadlines are met.
• Keep an intake log of referrals within assigned caseload.
• Make referrals to funding and service sources as needed and follow up on their progress.
• Conduct annual update visits for all active clients to ensure all forms and notification requirements are completed on time.
• Note and report significant changes in a client’s physical or mental condition or environment to appropriate persons or entities.
• Document and report any abuse, neglect, or exploitation to Adult Protective Services.
• Inform clients about safety, health, or fire hazards identified in their homes.
• Screen clients for extra community services, determine specific needs, and refer to other agencies or groups when appropriate.
• Coordinate special projects benefiting clients, such as holiday gifts or home and yard work by community groups.
• Obtain written diet prescriptions from clients’ physicians when a low potassium diet is needed.
• Assist with meal delivery as needed, including training new volunteer deliverers.
• Assist in answering and directing telephone calls to the proper person.
• Attend educational workshops and meetings to stay informed about services for the elderly and disabled in the community and issues affecting clients.
• Perform other duties as assigned by the Assistant Director.