GUIDE NaviGuide Service Coordinator

Community:
Ravines Edge Service Coordinator Responsibilities

• Assists and educates clients or residents and families to acquire and utilize community services necessary to maintain a self‑reliant lifestyle.
• Acts as a liaison between community agencies, service providers, and clients or residents; seeks out new services, identifies low‑cost providers, and/or negotiates discounts.
• Monitors the delivery of services to clients or residents to ensure services are appropriate, timely, and satisfactory.
• Maintains a resource directory of available community services.
• Maintains professional relationships with all clients or residents in the housing community to identify areas of need and make referrals to community agencies as necessary.
• Maintains resident files, including but not limited to intake information, assessments, service referrals, termination information, quarterly reviews and follow‑up, documentation of human or civil rights violations, and resident/family/provider meeting or communication notes.
• Conducts quarterly Quality Service reviews and follow‑up.
• Submits all required reporting data within specified time frames.
• Networks with service providers to maintain necessary relationships and pursue additional service opportunities through private, local, state, and federal sources.
• May require travel for conferences, training, and other company events.
• Performs all other duties as assigned or directed.
• Promotes wellness activities for all residents, including arranging onsite or mobile healthcare services and screenings; encourages residents to proactively address social, psychological, and physical needs.
• Coordinates educational events for residents, families, and staff regarding community resources (healthcare, home‑ and community‑based supports, benefits programs, life skills programs), including referral processes and eligibility requirements.
• Assists residents in building informal support networks with other residents, family members, and friends.
• Coordinates volunteer support programs with community service organizations.
• Assesses client needs to establish an individualized service plan.
• Acts as a family support system and provides community resources for caregivers as needed.
• Maintains client, family, and provider meeting and communication notes.
• Conducts home visits, including during inclement weather.
• Ability to commute daily for client home visits; requires daily travel to client homes, community service providers, and attendance at trainings, conferences, and company events.
• Completes all required GUIDE assessments, including FAST, ZBI‑22, PROMIS‑10, HRSN, and comprehensive assessments.
• Creates and updates person‑centered service plans to reflect changing client needs.
• Serves as a liaison between clients, caregivers, primary care physicians (PCPs), the GUIDE interdisciplinary team, community agencies, and service providers; seeks out new services to meet client needs.
• Maintains and updates resident files within the electronic medical record, including intake information, assessments, service plans, referrals, progress notes, and meeting/communication documentation.

• Education:
  
  Bachelor’s degree in social work – preferred. GUIDE Navi Guide:
  Associate degree in Nursing, Social Work, or Gerontology – preferred.
• Experience:
  
  Two (2) or more years of experience in social service delivery to the elderly population. Working knowledge of community resources within the geographic service area. GUIDE Navi Guide:
  Experience working with individuals living with Alzheimer’s disease, dementia, or in gerontology – preferred.
• Computer
  
  Skills:
  
  Must be able to proficiently operate a computer, the Internet, Microsoft Office, other relevant software, and basic office equipment.
• Certifications & Licenses:
  Membership and familiarity with the American Association of Service Coordinators – helpful. Driver’s license required; must meet company vehicle insurance and driving record standards. GUIDE Navi Guide:
  Certified Dementia Practitioner (CDP) or equivalent preferred.
• Other Requirements:
  Proven experience in service management or facilitation, including organizing, problem‑solving, and advocating;
  Must be able to read, write, understand and speak the English language;
  Must have strong interpersonal and communication skills;
  Must be able to work closely with residents, family members, legal representatives, and housing community staff;
  Must function independently, have a high level of flexibility and personal integrity;
  Must be able to adhere to all terms and conditions set forth in the United Church Homes Employee Handbook.

We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.