• AgeWays Nonprofit Senior Services
  • Remote
  • May 02, 2024
Full time Nonprofit-Social Services

Job Description

The RN Supports Coordinator (SC) uses person-centered principals to perform comprehensive assessments to determine health care, social needs of applicants, and eligibility for the MI Choice Waiver Program. Assess medical, functional, psychological, financial, and environmental needs of applicants. Coordinates support services to assist participants in developing a person-centered long-term care (LTC) plan. The SC may be expected to cover multiple counties of the MI Choice program area as needed. Community based staff schedule will accommodate daytime, evening and weekend hours as required.

Duties Include:

  • Conducts dual discipline in-person RN assessments for the purpose of evaluating MI Choice Program qualifications. Assessment tools per contract of iHC and NFLOC. Identify resources, organizations that may meet the participants' needs. Actively participate in linking the participants to needed services and LTC strategies/resources. Conduct monitoring contact calls for participants.
  • Community based staff performing in-home visits, must be able to accommodate daytime, evening and weekend hours as required. Models AgeWays values and mission.
  • Provide person-centered counseling on LTC options and strategies including the frequency, duration, and financing of services. Educate participants and caregivers regarding the participant's health status, health promotion, and risks and benefits of treatment options or personal choices, and work with family members and other volunteer caregivers to maximize available informal support systems and community resources. Determine gaps in care and develop overall Person-Centered Service Plan in managing participant's needs.
  • Demonstrate quality, adherence to department, contract and program standards, compliance through consistent audit outcomes conducted by quality department, Supervisor and other metrics identified by MDHHS, OIG, CSS Department, CQAR.
  • Complete case transfers to ongoing Supports Coordinator once approved by Quality department and Supervisor of Enrollments.
  • Develop and maintain cooperative relationships with other participant support systems and conduct referral and case conferencing activities as needed. Establish and maintain working relationships with physicians, hospital discharge planners, human service providers, home care agencies, Department of Human Services (DHS), and other referring agencies.
  • Maintain accurate records and participant files. Enter necessary information into the established participant tracking system. Meet quality requirements per contract/standards. Participate in peer reviews and quality activities. Report metrics.
  • Other duties as assigned.



  • RN Candidates: Minimum Assoc. or Nursing Degree with current State of MI nursing license required.
  • Candidates with Experience: Must have 2-4+ years of experience in clinical assessments or psycho-social assessments including home care experience and working with a similar target population.
  • Demonstrates problem solving ability and knowledge of LTC programs, eligibility requirements.
  • Excellent organizational skills and interpersonal skills.
  • Ability to work in a community-based setting, independently with little direct supervision of daily duties.
  • Strong computer skills required in MS Office Word, Excel, and Outlook; will test.
  • Valid driver's license required; will travel within a geographic region utilizing own reliable transportation.



Choice of 3 excellent next to zero cost Medical Plans including Dental and Vision.

401K - Agency contributes 50% match up to first 6% contribution.

Fitness and Wellness programs.

Excellent PTO package- Minimum 4 weeks accrual for the first year.

Get 10 paid holidays and 3 floating.

Mileage reimbursed for business travel.

Work schedules consist of hybrid, community-based, or office-based.

Our recruiting team would love to hear from you today! Please complete our on-line application and submit your resume for immediate consideration.

The AgeWays is an Equal Opportunity and Affirmative Action Employer.