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Habitat Health

PACE-based elder care provider and insurer

Home Care Coordinator

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeSan Leandro, CA, USA

About the Job

Requirements

  • A minimum of two years of clinical experience, preferably in home care, geriatrics, care coordination, primary care, or a related healthcare setting.
  • Knowledge of care planning, clinical assessments, and home care service delivery.
  • Ability to conduct comprehensive participant assessments and identify changes in condition or care needs.
  • Strong clinical judgment and critical thinking skills.
  • Excellent interpersonal, communication, and collaboration skills.
  • Ability to work effectively within an interdisciplinary team environment.
  • Strong organizational skills with the ability to manage multiple priorities and deadlines.
  • Proficiency with electronic health records and healthcare documentation systems.
  • Valid driver's license, reliable transportation, and active auto insurance in accordance with state requirements.
  • Ability to use motivational interviewing, trust-building techniques, and clear expectation setting to support acceptance of clinically appropriate home care hours and care recommendations.
  • Ability to travel between work sites or community locations as needed.
  • Ability to follow safety procedures and infection control protocols, and use personal protective equipment when required.
  • Ability to perform role-related tasks that may involve bending, reaching, lifting, or assisting participants, and to lift, carry, push, or pull supplies, equipment, or materials typically up to 25–50 pounds with assistance or mechanical aids, depending on job duties.
  • For team members working in a participant care setting, provide proof of COVID-19 and influenza vaccination or a signed declination form, and comply with applicable masking requirements, subject to applicable law and reasonable accommodation.
  • Comply with applicable infection control protocols, personal protective equipment requirements, and vaccination requirements associated with the role and work location.
  • Authorization to work in the United States, verified through E-Verify after acceptance of an offer and completion of Form I-9.

Responsibilities

  • Conduct comprehensive in-home assessments to evaluate participant care needs, functional status, safety risks, and appropriateness of home care services.
  • Perform home safety evaluations and provide recommendations to promote participant independence and reduce risk.
  • Assess participants' ability to safely perform tasks and use adaptive equipment through observation and return demonstrations.
  • Collaborate with participants, caregivers, and family members to identify care needs and service gaps.
  • Participate as an active member of the Interdisciplinary Team in developing, implementing, and updating participant care plans.
  • Partner with clinical and non-clinical team members, including rehabilitation, nutrition, and social services staff, to ensure a comprehensive understanding of participant needs.
  • Coordinate home care services to align with participants' individualized care plans and goals.
  • Evaluate completed caregiver tasks and identify services that are frequently declined, missed, or not completed as planned.
  • Review weekly home care notes and documentation to identify service gaps, changes in participant condition, Service Determination Requests, grievances, and other concerns requiring follow-up or escalation to appropriate team members.
  • Maintain current and accurate authorizations for home care services, ensuring services are aligned with participant needs and payer requirements.
  • Monitor authorization status and coordinate renewals to prevent interruptions in service.
  • Maintain timely, accurate, and compliant documentation in electronic health records and operational systems.
  • Support quality improvement initiatives and compliance activities related to home care services.
  • Perform other related duties as assigned.

Desired Qualifications

  • Active Licensed Vocational Nurse license in the applicable state.
  • Experience working with older adult populations.
  • Experience in PACE, home health, home care, or managed care environments.
  • Bilingual ability in Spanish, Mandarin, or Cantonese.
  • Experience with care coordination, utilization management, or authorization processes.

About the Company

Habitat Health

PACE-based elder care provider and insurer

Habitat Health coordinates medical care, social services, and daily living support for older adults to help them stay in their homes and communities. It operates under the Program of All-Inclusive Care for the Elderly (PACE), which lets it act as both a healthcare provider and an insurer, delivering a bundled set of services including primary and specialty care, mental health, prescription management, rehabilitation, transportation, nutrition support, adult day activities, and home visits within a single framework. The organization differentiates itself through its dual provider/insurer model and its home- and community-focused, holistic approach, starting with a Sacramento pilot in partnership with Kaiser Permanente and backed by major venture investors. Its goal is to expand access to integrated, coordinated care for seniors, helping them maintain independence and avoid long-term institutional care.

Company size
51-200
Company stage
Early VC
Total funding
$50M
Headquarters
San Francisco, CA
Founded
2023

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