Transitional Care Coordinator

Nestled in San Franciscos Excelsior neighborhood on a nine-acre campus the San Francisco Campus for Jewish Living (SFCJL) is the leading senior services organization in Northern California. Our continuum of care includes: the Frank Residences assisted living and memory care; the Jewish Home and Rehabilitation Center offering long-term skilled nursing short-term rehabilitation an acute geriatric psychiatric unit for adults over the age of 65; and our Foundation.

Founded in 1871 and formerly known as the Jewish Home our legacy grounds us as our vision propels us forward. Today weve evolved to support more than 2500 older adults each year through innovative comprehensive programs rooted in the Jewish values of compassion community and excellence. We are equally proud of our inclusive culture where 950 team members of diverse faiths and backgrounds work together in shared purpose.

WHY WORK WITH US

• Mission-driven nonprofit organization
• Competitive compensation and comprehensive benefits
• Meaningful work that positively impacts the lives of older adults every day
• Inclusive community welcoming to all (you do not need to be Jewish to live or work here)
• Supportive team-oriented environment
• Opportunities for professional growth and development
• Collaborative leadership focused on enhancing the employee experience

POSITION SUMMARY

As a Transitional Care Coordinator (TCC) you will provide psychosocial support to patients and their families facilitate discharge planning meet documentation requirements and function as a member of the interdisciplinary care team at the Jewish Home & Rehab Center. This role supports the planning organization implementation and evaluation of Social Services operations in accordance with federal state and local regulations as well as the facilitys established policies and procedures.

KEY RESPONSIBILITIES

• Coordinate with the interdisciplinary team and other departments in the provision of social services and discharge planning.
• Complete comprehensive psychosocial assessments of patients within the appropriate timeframe.
• Act as a liaison between patients their families internal departments and community referral partners throughout the patients stay in Short-Term Rehabilitation and Long-Term Care.
• Assist patients and families in accessing concrete services and resources.
• Demonstrate knowledge of and ability to utilize community resources effectively.
• Respond to crisis situations involving patients families and staff with guidance from supervisors.
• Facilitate individual counseling for patients and families as needed.
• Participate in the development of patient care plans and establish appropriate goals and treatment interventions for social services.
• Encourage residents and responsible parties to participate in care planning and attend care plan meetings.
• Maintain accurate and timely documentation in compliance with federal and state regulations and Jewish Home policies including but not limited to Initial Assessments Psychosocial/Mental Status Assessments Care Plans Social Service Progress Notes and Discharge Planning documentation.
• Maintain confidentiality of all patient and facility information.
• Serve as a patient advocate and ensure patients are informed of their rights responsibilities and insurance benefits as well as any changes that may affect them.
• Perform other duties as assigned by the Director of Social Services.

JOB DETAILS

• Pay Rate: $34 $36 per hour
• Hours: Full-Time 40 hours per week
• Shift Schedule: 8:00 AM - 5:00 PM
• Days Off: Saturday and Sunday
• Working Days: Monday through Friday

REQUIRED QUALIFICATIONS

• Bachelors degree in Social Work or a related human services field including but not limited to sociology gerontology rehabilitation counseling or psychology.
• Minimum of one (1) year of supervised social work experience in a healthcare setting working directly with individuals.
• Minimum of one (1) year of experience with case management and discharge planning.
• Strong interpersonal skills and ability to work collaboratively as part of an interdisciplinary team.
• Ability to communicate effectively with patients families and staff at all levels of the organization.
• Effective time management skills with the ability to organize and prioritize workload.
• Understanding of Medicare and Medi-Cal guidelines.
• Knowledge of medical terminology preferred.

PHYSICAL REQUIREMENTS

• Ability to lift push or pull a minimum of fifteen (15) pounds.
• Ability to exert muscle force to lift push pull or carry objects.
• Ability to use abdominal and lower back muscles over time without fatigue.
• Ability to stand and/or sit for extended periods.
• Ability to bend stoop stretch twist sit and reach.
• Fine motor skills and good visual and auditory acuity.
• Ability to maintain composure in stressful situations and work effectively under pressure.
• Ability to interact tactfully with residents families staff visitors government agencies and the public.
• Ability to make independent decisions when circumstances require.
• Ability to relay important information concerning a residents condition to appropriate staff.
• Ability to maintain a positive attitude and contribute to a collaborative team environment.

OUR INVESTMENT IN YOU

Comprehensive benefits including Medical Dental and Vision coverage; a 403(b) Retirement Plan; Paid Time Off (PTO); Tuition Reimbursement; Commuter Benefits; and Weekday Shuttle Service to and from Glen Park BART Station.

The San Francisco Campus for Jewish Living is committed to fostering a diverse equitable and inclusive workplace. We provide equal employment opportunities to all qualified individuals without regard to race color religion gender age national origin marital status sexual orientation gender identity veteran status genetic information disability or any other characteristic protected by applicable law.

Pursuant to the San Francisco Fair Chance Ordinance we will consider qualified applicants with arrest and conviction records for employment.