Care Manager
Bergen Family Center
Job Description
Job Description
POSITION: Full-Time Care Manager – Social Isolation Grant
REPORTS TO: OLDER ADULT SERVICES DIRECTOR
SUMMARY OF POSITION
Responsible for delivering grant-funded care management services to older adults, including conducting needs assessments, addressing social isolation, and developing individualized care plans to meet program goals and improve participant well-being. Provides in-home and telephone-based support, connects participants to community resources, and ensures compliance with grant requirements through data collection, surveys, and outcome tracking. Collaborates with community providers and identifies additional service needs, making appropriate referrals to enhance client support and independence.
QUALIFICATIONS
- Associate’s or Bachelor’s degree in Social Work or related field (preferred)
- Minimum of two years’ experience working with older adults preferred
- Case management experience preferred
- Experience with community-based or grant-funded programs a plus
- Bilingual (English/Spanish) required
- Valid NJ driver’s license required
- Ability to pass all required background checks
- Ability to work a flexible schedule to meet participant needs
SKILLS
- Strong communication and interpersonal skills
- Ability to build rapport with older adults and their families
- Knowledge of local eldercare and community resources
- Experience with data collection, surveys, and documentation
- Ability to assess social isolation and identify service needs
- Strong organizational and time management skills
- Ability to manage caseloads and work collaboratively with community providers
RESPONSIBILITIES
- Perform regular face-to-face home visits with clients
- Conduct comprehensive at-home assessment
- Develop and implement a care plan and goals based on assessment and client’s needs
- Evaluate and update care plan on a regular basis
- Communicate regularly with family members and related professionals
- Cultivate and maintain extensive knowledge of providers and community resources, and link clients to appropriate services
- Document assessment, ongoing progress, and all the services provided in data system in accordance with established documentation procedures
- Be an advocate for clients and their families and educate them about the benefits available to them including community, state, and federal program
- Provide in-home visits and telephone outreach to older adults to reduce social isolation and enhance overall well-being
- Conduct comprehensive assessments to identify client needs, risks, and barriers to engagement
- Develop, implement, and monitor individualized care plans aligned with grant objectives
- Connect participants to appropriate community resources, benefits, and support services
- Administer surveys and collect required data to meet grant reporting and compliance standards
- Maintain accurate and timely documentation of client interactions, services, and outcomes
- Conduct follow-up contacts to evaluate progress and adjust care plans as needed
- Collaborate with families, caregivers, and service providers to coordinate initiatives as needed
- Support program evaluation efforts by tracking participant engagement and outcomes
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