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 Mass Health and program regulations.

Loved Ones Care is a Mass Health 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.

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.

• 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.

• 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.

• Collaborate with:
  • Physicians
  • Hospitals
  • Skilled nursing facilities
  • Elder Service Agencies
  • Independent Living Centers
  • Behavioral health providers
  • Home health agencies
  • Mass Health managed care plans
• Coordinate referrals for additional community resources and services.

• Complete all required assessments and documentation accurately and on time.
• Maintain electronic member records in Homecare GPS and other agency systems.
• Ensure compliance with Mass Health 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.

• 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.

• Participate in interdisciplinary team meetings.
• Assist with accreditation and regulatory compliance initiatives.
• Support continuous quality improvement efforts.
• Participate in emergency preparedness planning.

• 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…