Case Manager (CM) - Adult Family Care (AFC) & Group Adult Foster Care (GAFC)

Make a Difference Every Day Are you passionate about helping individuals remain safe, healthy, and independent in their homes? Loved Ones Care is seeking a compassionate and organized Case Manager (CM) to coordinate services for members enrolled in our Adult Family Care (AFC) and Group Adult Foster Care (GAFC) programs. As a Case Manager, you will be the primary point of contact for members, caregivers, referral sources, and healthcare providers. You will ensure members receive high-quality, person-centered care while maintaining compliance with MassHealth and program regulations. About Loved Ones Care Loved Ones Care is a MassHealth provider of: Adult Family Care (AFC) Group Adult Foster Care (GAFC) Personal Care Homemaking Services Our mission is to enrich lives by providing compassionate, high-quality care that allows individuals to remain safely in their homes while preserving their independence and dignity. Position Summary The Case Manager is responsible for coordinating all aspects of member care from referral through ongoing case management. This includes completing assessments, coordinating admissions, maintaining communication with caregivers and healthcare providers, ensuring regulatory compliance, and supporting members throughout their enrollment. Key Responsibilities Member Care Coordination Coordinate admissions for AFC and GAFC members. Conduct initial home visits and ongoing case management visits. Complete psychosocial assessments and required program documentation. Develop, implement, and update individualized service plans in collaboration with the interdisciplinary team. Monitor members' health, safety, and overall well-being. Identify changes in condition and promptly notify the clinical team. Coordinate hospital admissions, discharges, rehabilitation stays, and service resumptions. Maintain regular communication with members, caregivers, and families. Caregiver Support Educate caregivers regarding AFC/GAFC program requirements. Provide ongoing support, coaching, and problem-solving. Monitor caregiver performance and member satisfaction. Coordinate respite and backup care when needed. Care Coordination Collaborate with: Physicians Hospitals Skilled nursing facilities Elder Service Agencies Independent Living Centers Behavioral health providers Home health agencies MassHealth managed care plans Coordinate referrals for additional community resources and services. Documentation & Compliance Complete all required assessments and documentation accurately and on time. Maintain electronic member records in Homecare GPS and other agency systems. Ensure compliance with MassHealth AFC and GAFC regulations. Maintain accurate case notes, progress notes, and service documentation. Assist with Prior Authorization tracking and required paperwork. Participate in quality assurance activities and audits. Admissions & Referrals Receive and process new referrals. Coordinate intake appointments. Obtain medical documentation from physicians. Monitor outstanding paperwork and follow up with providers. Coordinate Start of Care (SOC) scheduling. Maintain referral tracking logs. Quality Improvement Participate in interdisciplinary team meetings. Assist with accreditation and regulatory compliance initiatives. Support continuous quality improvement efforts. Participate in emergency preparedness planning. Qualifications Required Bachelor's degree in Social Work, Human Services, Psychology, Nursing, or a related field preferred. Equivalent experience in case management or community health may be considered. Minimum one year of experience in case management, home care, AFC, GAFC, behavioral health, aging services, or a related field. Excellent communication and interpersonal skills. Strong organizational and time management abilities. Ability to work independently and manage multiple priorities. Reliable transportation, valid driver's license, and current automobile insurance. Ability to travel throughout assigned service areas. Proficiency with Microsoft Office and electronic health record systems. Preferred Experience with MassHealth programs. AFC or GAFC experience. Knowledge of MDS-HC assessments and AFC/GAFC regulations. Experience working with Elder Services, ASAPs, Independent Living Centers, or behavioral health agencies. Bilingual (Spanish, Haitian Creole, Khmer, Portuguese, or other languages) is a plus. Benefits Loved Ones Care offers: Competitive salary Flexible scheduling Paid sick time Mileage reimbursement (when applicable) Paid orientation and ongoing training Career advancement opportunities Supportive leadership team Casual dress Free parking, including garage parking during the winter Community-focused work environment Why Join Loved Ones Care? At Loved Ones Care, you'll have the opportunity to build lasting relationships with members and families while helping individuals remain independent in their homes. You'll work alongside a collaborative interdisciplinary team committed to delivering compassionate, high-quality care throughout Massachusetts. Your work will directly improve the quality of life for vulnerable adults and help families navigate the healthcare system with confidence and support. Loved Ones Care LLC 354 Merrimack St., Suite 272 Lawrence, MA 01843 Phone: View phone number on click.appcast.io Fax: View phone number on click.appcast.io Email: View email address on click.appcast.io Website: Loved Ones Care LLC is an Equal Opportunity Employer. #J-18808-Ljbffr Loved Ones Care