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Posted August 23, 2026

Community Health Coordinator

Appalachian Agency For Senior Citizens Inc
Falls Mills, VA, US Full Time

Job Description

Job Description

Job Title: Community Health Coordinator

JOB SUMMARY

Provides person-centered counseling services to Veterans enrolled in the Veterans Directed Care program and supports the care coordination department with other clients as needed. VDC is a program that serves eligible veterans of any age who are at risk of nursing home placement. The Community Health Coordinator is responsible for educating Veterans on the Veteran-Directed Care (VDC) program, as Advocate and coach, the Community Health Coordinator works with the Veteran to identify their needs and develop a Spending Plan to meet those needs. He or she works with the Veteran to assess, identify, coordinate and monitor supports and services on an ongoing basis. The Community Health Coordinator supports the Veteran in the creation and management of their individualized Spending Plan. The Community Health Coordinator monitors all VDC spending along with the Veteran, the Financial Management Service (FMS) provider and the VAMC.

ESSENTIAL FUNCTIONS

  1. Home visits (50% including travel time): This includes initial assessments, development of a spending plan, assisting the Veteran with the process of becoming an employer, facilitating new hire appointments, conducting monthly, quarterly, semi-annual, and annual required contacts and reassessments as needed. Provide training and remediation as necessary related to employer responsibilities. Suggested maximum case load 50 veterans per Community Health Coordinator.
  2. Office work (50%): Follow up on referrals and service implementations for clients. Maintains, updates, and monitors clients' confidential information, services and file notes in database program as required. Performs fiscal duties as required under Veterans Directed Care program. Maintains accurate records of expenditures, schedules & generates monthly reports as required; responsible for satellite office administration as assigned.
  3. Provide liaison services between agency programs and potential clients
  4. Performs data entry in agency client tracking program
  5. Maintain strict confidentiality concerning all information pertaining to clients and program operations
  6. Performs other agency-related services as warranted
  7. Demonstrate and maintain good work ethics
  8. Stays current in the knowledge of the profession, community resources and funding opportunities available to seniors and disabled adults. Utilizes knowledge in advocacy of-client needs.
  9. Maintains travel schedule and related expense reports. Organizes and prioritizes schedule and duties independently.
  10. Maintain ongoing relationships with other professionals, medical providers, and contractors on behalf of Agency.
  11. Work in and away from the office, including community events as assigned.

KNOWLEDGE, SKILLS AND ABILITIES

Has knowledge of:

  • HIPAA regulations and general Medicaid & Medicare eligibility criteria.
  • Computers and Microsoft Office programs (e.g., word processing, spreadsheet, PowerPoint, e-mail).
  • Appalachian Agency for Senior Citizens policies and procedures.
  • Ability to work independently to accomplish goals and advocate for clients, families, community partners.

WORKING ENVIRONMENT

Office-based position with minimal physical requirements (ability to lift 15 lbs., walking and climbing stairs). Requires regular independent travel around the area served by Appalachian Agency for Senior Citizens. Some essential functions of the position can be performed remotely.

Appalachian Agency for Senior Citizens is an Equal Opportunity Employer. All applicants will be considered for employment without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, veteran, or disability status.

Disclaimer: This job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee. From time to time, the supervisor will ask job holder to perform additional duties related to the completion of the work.

MINIMUM QUALIFICATIONS

  • Bachelor’s degree in social work, human services or medical field or equivalent experience preferred.
  • 3 or more years of experience working with seniors, disabled adults, human services or general case management field is preferred.
  • A criminal History background check is required.
  • Must possess a valid driver's license and proof of current PPD test.

BENEFITS

  • Offering competitive pay, generous leave policy and a family friendly work environment.
  • 15 paid holidays, Medical, Dental, and Vision coverage, Retirement, Short- and Long-term disability benefits, Critical Illness, Accident and Life Insurance.

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