Understanding and empathizing with client needs
Surpassing client expectations
Demonstrating a high level of integrity and work ethics
Exhibiting compassion and commitment
Advocating for social justice
Taking pride in individual work as well as that of the team
Continually learning to stay current with industry standards, best practices and technology
Utilizing AIDET skills at all times
As a Sea Mar employee, the individual in this position commits to adherence to these values to their utmost ability and endeavors to strengthen and embody this mission daily. The Infant Case Manager:
Is able provide six core services: health promotion, support to client/family, care coordination, referral to social and community resources, care management.
Conducts mandatory screenings and optional screenings when indicated to identify care needs.
Creates a health action plan (HAP) with the client and/or family including long term goal, short-term goal, small actionable steps to meet goals.
Prior to HAP, reviews screenings and electronic record and when appropriate reaches out to other service providers with whom client has had contact to consult how to best support their goals and ensure non-duplicative efforts.
Uses motivational interviewing and behavioral activation techniques with clients as an adjunct to other techniques to assist the client to achieve HAP goals and progression toward client activation.
Reviews health action plan and screenings with client and/or family every four months.
Works with the clients/families to integrate self-care into their activities of daily living.
Demonstrates knowledge and skills necessary to provide care appropriate to the age of the clients served.
Participates in case conference with all appropriate team members. When care plans are ineffective, provides recommendations in collaboration with client for change to health action plan.
Presents caseload to interdisciplinary team members in order to receive expertise of team (from RN and from SW or MSW).
Participates in regular consultation with behavioral health providers when working with clients with behavioral health diagnoses who are seeing behavioral health therapist.
As appropriate coordinates with community providers and case managers on client’s behalf.
Must maintain appointment reconciliation in scheduling database
Demonstrate knowledge of the principles of growth and development over the life span
Work independently with parenting low-income families who meet specific high-risk criteria
Develop and implement ongoing written plan of care with family which includes identified needs, goals, and outcomes
Refer and link infant/family with other agencies and programs to meet identified need
Advocate and assist client to overcome barriers to obtaining services Other duties as assigned. Personnel and Performance Metrics: The Infant Case Manager will:
Adhere to his/her established schedule and must be prepared to provide services and/or engage in other work related duties by her/his established start time, each day.
Provide services using AIDET skills at all times, for both, external and internal customers.