OCES is growing!
We are expanding to 11 more towns covering the south shore area, including Quincy, Braintree, Weymouth, etc.
OCES supports older adults and individuals with disabilities by providing vital information and coordination of services. By promoting healthy, safe living for our consumers, we hope to allow them to stay active and engaged in their lives and in their own communities for as long as possible.
Our mission Through the talents of an experienced and diverse workforce, OCES supports the independence and dignity of older adults and individuals with disabilities by providing essential information and services that promote healthy, safe living which positively impacts our community.
We are seeking a Community Transition Liaison to facilitate successful discharge activities and other support activities for assigned consumers focusing on the transition from nursing facilities (NF) to community. The Community Transition Liaison is responsible for facilitating successful discharge activities and other support activities for assigned consumers focusing on the transition from nursing facilities (NF) to community.
What you will do:
• Acts as onsite point of contact for residents, families, health care proxy (HCP)and NF staff
related to transitions from NF to community
• Visits with residents to increase awareness of service and introduce transition to the community
as a potential option
• Participates in resident, family and/or HCP conversations to inform options and transition
planning
• Completes the directional screening tool to determine potential appropriateness for referrals to
HCBS Waivers and other programs to support the transition to the community and meet the
consumer's needs once in the community setting
• Facilitates person-centered planning and needs assessment
• Begins the process of gathering necessary documentation and identification needed for housing
applications and other public benefits
• Completes referrals to other programs and follows-up on referrals to ensure timely transition
• Participates in Interdisciplinary Discharge Planning (IDP) meetings and facilitates communication
among the consumer, family members and community agencies.
• Participates and facilitates in discharge planning meetings with the consumer, family, nursing
facility staff and other agencies that will support the consumer in the community upon
discharge
• Coordinates with state programs and teams
• Maintaining case records in compliance with regulations, standards, and protocols
• Maintaining knowledge of current OCES policies and standards, and funding source regulations
• Other duties as assigned.
What you will bring:
• Bachelor's degree in nursing, social work, human services, or related field
• Current Social Work License preferred
• Must possess knowledge of long-term care, case management, discharge planning, community
resources, programs, and benefits to help support an individual's transition from an institutional
to a community setting
• Two years of experience in the social services field including a minimum of one year of experience
with transition support activities
• Excellent verbal and written communication skills.
• Excellent interpersonal and conflict resolution skills.
• Excellent organizational skills and attention to detail.
• Strong analytical and problem-solving skills.
• Strong supervisory and leadership skills.
• Proficient with Microsoft Office Suite or related software
What you will get:
APPLY TODAY!
OCES is an open, welcoming organization that respects our diversity. We encourage all qualified people to apply!
The mission of Old Colony Elder Services (OCES) is to support the independence and dignity of older adults and individuals with disabilities by providing essential information and services that promote healthy and safe living.
OCES proudly serves greater Plymouth County and surrounding communities. OCES is a private, non-profit organization headquartered in Brockton and designated as one of 25 Aging Services Access Points (ASAPs) in the Commonwealth of Massachusetts. We are governed by a Board of Directors, which includes representatives from the 23 communities in our ASAP service area.
Since 1974, OCES has been providing a variety of services to those individuals most in need. Through our programs we offer significant life-supporting care contributing to an individual’s ability to live within the community as independently as possible for as long as possible while preserving dignity and quality of life. OCES is the largest provider of these in-home and community-based services for older adults and people living with disabilities in the southeastern part of Massachusetts.
