ESSENTIAL:

• Assesses senior residents to establish a care plan according to their needs.
• Lead workshops for residents on issues related to elder care, senior referrals and rights, end-of-life planning.
• Encourage residents to participate in on-going wellness and social activities.
• Provide advocacy and education to seniors
• Facilitate coordinated care for targeted critical/high need tenant cases.
• Works with resident and their families to discuss options to help residents age in place.
• Completes documentation, both paper and electronic in a timely manner.
• Provide counseling and therapy.
• Provide in-service training and be available to consult with staff.
• Conduct and prepare assessments, case logs, documents case notes, care plans for tenants.
• Refer and link tenants to service providers in the local community.
• Establish and maintain contacts with families and health facilities when resident’s s are in hospitals and rehab facilities, and helps formulate aftercare plans.
• Responds to emergency situations and provide crisis intervention.
• Contact and follow-up with service providers put in place for tenants such as Adult Protective Services, outpatient behavioral health, substance use treatment and healthcare providers.
• Strictly adheres to and enforces all the Agency policies regarding Confidentiality and Corporate Compliance regulations and maintains compliance with HIPAA regulations.
• Offer time-limited groups as appropriate on such issues as loss and depression, living with illness, substance use issues and family/relationship maintenance.

OTHER DUTIES:

• Participation as needed to Agency’s response to serious incidents and critical debriefing.
• Participate in the development and facilitation of staff training and in-services for social service, property management staff on relevant social service topics.
• Participating on Agency committees as needed.
• Participate in in-service trainings related to management and/or related behavioral health.
• Partner with building property management and maintenance staff to identify and respond to targeted tenants in need.
• Collaborate with Agency and program staff to develop and adhere to on-site emergency response preparedness and readiness protocols.
• Identifying and reporting issues that may reflect negatively on the reputation of the agency, client and/or staff welfare or any corporate compliance issue.
• Liaise with CCNS departments, including Integrated Health and Wellness, Family and Community Services, Community Programming, Office of Mission, as appropriate.
• Incorporate Agency determined Best Practices, Integrated Delivery and/or Evidence Based Practices models as needed.
• Attend staff meetings, workshops, classes, & in-service trainings on a regular basis to maintain current information on eligibility requirements for all basic entitlements.
• Perform other duties as assigned.

SPECIFICATIONS FOR EDUCATION

·        Bachelor of Science in Nursing (BSN) required. 

·        NYS Registered Nurse (RN)

SPECIFICATIONS FOR EXPERIENCE AND TRAINING

• Must have certification in gerontology or 3 years of experience working with the geriatric population.
• Excellent time management, organizational and computer skills.
• Demonstrated experience working with family/communities developing social, educational, and health related programs.
• The position requires a combination of skills in the areas of crisis intervention, time management, psychosocial rehabilitation skills
• Must be well organized & computer literate.
• Strong leadership skills and ability to motivate others.
• Ability in linking clients to a broad range of services essential to successfully living in a community setting (e.g., medical, psychiatric, social, educational, legal, housing and financial services). 
• Must have excellent communication skills, oral and written.
• Cross-cultural competency, outreach, interviewing, listening, advocating, linking, negotiating, engagement, monitoring and clinical assessment skills are essential.
• Bilingual preferred (Chinese, Korean, Russian, Spanish)

SPECIFICATION FOR PHYSICAL REQUIREMENTS

• Regularly required to talk, hear, walk, stand, and sit. 
• Able to climb stairs.
• Able to operate a computer keyboard, mouse & office equipment.
• Ability to read printed materials and computer screens.
• Ability to work flexible hours (evenings/weekends) as assigned.
• Able to travel throughout the five boroughs as needed.
• Ability to lift up to 10lbs.
• May be required to meet with tenants and / or staff throughout facilities.
• Frequently sitting to write reports and when meeting with tenants.