Transition Team Coordinator
The Transition Team Coordinator coordinates the care of an identified behavioral health population throughout the healthcare continuum; Acts as part of a multidisciplinary team and contributes to the development of a comprehensive plan of care based on assessment of psychosocial, life skills, and career development needs of the participants.
Essential Roles and Responsibilities Take the lead on child placement practice within an inter-disciplinary team Act as the primary team member for communication with referring agency workers Conduct assessments of new participants within 30 days of admission, in accordance with the New Pathways Theory of Change protocol Schedule and facilitate case plan meetings for participants and interdisciplinary team members in conjunction with COMAR Develop and implement written Independent Living Case Plans for program participants Monitor participant's progress towards goal achievement by meeting directly with participants in their living environment.
Prescribe visit dosage determined by the phase of programming Assist participants in the identification and creation of their own social support network Assist participants by identifying and addressing those behaviors that are most likely to create or facilitate instability in their environment (ie drug use, gang involvement, arrest, pregnancies) Network with other community organizations to refer participants for education, mental health, physical health, support, and/or vocational training as necessary Maintain specified regular contact with all participants on the caseload Maintain contact with agencies and programs with which clients are involved to lend appropriate support and direction Maintain client case records in accordance with licensing regulations and agency policy Utilize written computer-based documentation and database entry to record youth's physical environment and goal achievement performance according the policies and procedures Carry and respond to cellular phone in a timely manner during work hours When necessary, complete incident reports according to New Pathways policies and procedures Attend all meetings and events relative to the progress of the youth on caseload Respond to the youths' needs based on their level of self-sufficiency and established goals Assist the transition team in recognizing and managing mental health and psychosocial issues Communicate and collaborate with DSS/DJS workers to ensure understanding of transition plan Monitor participants' progress towards established goals; evaluate and modify plans of care Ensure Physical, Vision, Dental appointments and documentation are in compliance Provide on-call backup as needed Essential Qualifications Education/ Credentials/ Licensure:
Bachelor's Degree in Social Work from an accredited college and Maryland Social Work License Current Maryland Driver's License with acceptable driving record and proof of current automobile insurance and reliable transportation is required Working Conditions Physical Demands:
Ability to lift/carry at least 20 pounds (laptop, files, etc.
) Must be able to operate a computer keyboard and a smartphone, required.
(manual dexterity) Must be able to operate agency vans as well as personal vehicle safely during required work hours Must be able to manage stress well Environmental:
Familiarity with Prince George's Metropolitan area Ability to negotiate diverse/multi-leveled buildings and living environments that do not have elevators The TTC works from an apartment based office, the participants' homes at appointment times, and in the community Required local travel is 25%of the time.
Working Hours Must be able to work full-time weekly business hours on a consistent basis with the flexibility to adjust hours based on the needs of the participants and the organization.
One flexible evening per week up to 7:
00 pm is required.
Emergency on-call duties as assigned Clearances:
State Police/FBI per state regulations; Child and Adult Protected services.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
Essential Roles and Responsibilities Take the lead on child placement practice within an inter-disciplinary team Act as the primary team member for communication with referring agency workers Conduct assessments of new participants within 30 days of admission, in accordance with the New Pathways Theory of Change protocol Schedule and facilitate case plan meetings for participants and interdisciplinary team members in conjunction with COMAR Develop and implement written Independent Living Case Plans for program participants Monitor participant's progress towards goal achievement by meeting directly with participants in their living environment.
Prescribe visit dosage determined by the phase of programming Assist participants in the identification and creation of their own social support network Assist participants by identifying and addressing those behaviors that are most likely to create or facilitate instability in their environment (ie drug use, gang involvement, arrest, pregnancies) Network with other community organizations to refer participants for education, mental health, physical health, support, and/or vocational training as necessary Maintain specified regular contact with all participants on the caseload Maintain contact with agencies and programs with which clients are involved to lend appropriate support and direction Maintain client case records in accordance with licensing regulations and agency policy Utilize written computer-based documentation and database entry to record youth's physical environment and goal achievement performance according the policies and procedures Carry and respond to cellular phone in a timely manner during work hours When necessary, complete incident reports according to New Pathways policies and procedures Attend all meetings and events relative to the progress of the youth on caseload Respond to the youths' needs based on their level of self-sufficiency and established goals Assist the transition team in recognizing and managing mental health and psychosocial issues Communicate and collaborate with DSS/DJS workers to ensure understanding of transition plan Monitor participants' progress towards established goals; evaluate and modify plans of care Ensure Physical, Vision, Dental appointments and documentation are in compliance Provide on-call backup as needed Essential Qualifications Education/ Credentials/ Licensure:
Bachelor's Degree in Social Work from an accredited college and Maryland Social Work License Current Maryland Driver's License with acceptable driving record and proof of current automobile insurance and reliable transportation is required Working Conditions Physical Demands:
Ability to lift/carry at least 20 pounds (laptop, files, etc.
) Must be able to operate a computer keyboard and a smartphone, required.
(manual dexterity) Must be able to operate agency vans as well as personal vehicle safely during required work hours Must be able to manage stress well Environmental:
Familiarity with Prince George's Metropolitan area Ability to negotiate diverse/multi-leveled buildings and living environments that do not have elevators The TTC works from an apartment based office, the participants' homes at appointment times, and in the community Required local travel is 25%of the time.
Working Hours Must be able to work full-time weekly business hours on a consistent basis with the flexibility to adjust hours based on the needs of the participants and the organization.
One flexible evening per week up to 7:
00 pm is required.
Emergency on-call duties as assigned Clearances:
State Police/FBI per state regulations; Child and Adult Protected services.
.
Estimated Salary: $20 to $28 per hour based on qualifications.
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