Service Coordinator II

Position Summary

Under the direction of the Client Services Manager-Intensive Unit,  provides in home care coordination services to 50+ frail elderly and people with disabilities requiring home care services to continue living independently in the community. The Service Coordinator II conducts in-home assessments, provides intensive case management, develops service plans, facilitates linkages in the community, conducts follow up to assure that linkages have been made,  and provides advocacy to frail elderly and people with disabilities.  The Service Coordinator II ensures all clients receive adequate home care hours to meet their needs and ensures that services delivered are of high quality and in compliance with Homebridge’s contract provisions, policies and procedures, and are within the scope of the agency’s resources and mission.

Essential Job Functions

Direct Client Services

  • Conducts visit in clients’ homes to perform Initial Assessment of clients’ needs
  • Using the number of authorized hours as a guide, determines requested hours, i.e. the number of hours of service clients state that will meet their needs
  • Based on numbers of hours requested, with the client, defines number hours per shift and number of shifts per week; conveys information and client preferences to the staff Scheduler using Dated Notes in database
  • Defines Client Acuity and Care Needs and Home Care Services delivery
  • With clients, completes Client Care Plans and Service Plans; documents all in database
  • Has clients sign all required forms
  • Conducts formal Reassessments of client’s needs at minimum three times a year; hours of service requested and Client Care Plan are also updated; documents reassessments in a timely fashion
  • Conducts check-ins with clients on a monthly basis over the phone or in person
  • Works closely with Service Delivery staff to make sure Home Care Provider (HCP) is matched appropriately to client and is scheduled to maximize client hours 
  • Monitors hours of service delivered, quality of service delivery, client satisfaction and changes in client’s functional status
  • Provides advocacy, information and assistance, and acts as a liaison with other social service agencies that provide services for older adults and people with disabilities
  • Consults with client and other members of the client’s team to determine the level of care needed to maintain independence
  • Collaborates with HCP Supervisor to make sure HCP performs duties as described in the task list of the Client Care Plan
  • Introduces HCP to client at first visit when possible and necessary; reviews Client Care Plan with client and HCP
  • Updates the database with Dated Notes, accurately and in a timely fashion
  • Coordinates Heavy Cleanings and Paramedical Care for specified clients
  • Trouble shoots obstacles to providing effective home care, such as lack of cleaning supplies, client resistance, client behaviors; creates behavior contracts as needed
  • Monitors hospitalizations and hospital discharge plans, ensuring home care is delivered post discharge as needed
  • Based on changing client needs, facilitates hours changes and status changes with IHSS, the HCP(s), and Scheduler; submits documentation requesting increases or decreases in authorized hours
  • Coordinates Wellness Checks and the creation of Homebridge accounts
  • Reports clients who are unsafe or at-risk for abuse or neglect to Adult Protective Services.  Complies with Welfare & Institutions Code (W&I) section 15630(a) California law (mandated reporter) requiring Homebridge employees to report known or suspected abuse of dependent adults or elder, immediately by telephone or as soon as practically possible, and by written report with two (2) working days (W&I) section 15630(b)
  • Refers clients for resources outside the scope of Homebridge case management duties
  • Acts as Officer of the Day on a regular basis
  • Receives and follows up on client complaints, initiating investigations of allegations made by clients


  • Completes Assessments, Reassessments, Care Plans, Service Plans, and Dated Notes in a timely fashion
  • Maintains client (hard copy and soft copy) files
  • Reviews all e-mails, voice mails and mail in real time
  • Completes Bi-Weekly Timesheets and Monthly Data Form


  • Actively participates in supervision, case manager team meetings, and agency meetings
  • In supervision, creates a personal development plan; follows up on activities in the plan
  • Complies with all Homebridge policies and procedures

Knowledge, Skills, and Abilities

  • Is committed to the agency’s mission to delivery of high-quality services
  • Possesses good working knowledge of Medicare, Medi-Cal, and other entitlement programs  
  • Able to identify and coordinate appropriate community services for clients
  • Actively incorporates the ethical standards of the National Association of Social Workers in all aspects of interactions with others
  • Able to be compassionate and empathetic with clients, often in stressful and difficult situations
  • Able to develop practical and innovative solutions to client problems
  • Proficient in use of Microsoft Office and able to quickly master use of proprietary software
  • Able to manage time effectively, work under pressure, prioritize, problem-solve and meet deadlines
  • Fosters collaboration with all departments, community partners, contracting agencies and maintains open communication channels
  • Is dependable and positive
  • Is skilled at communicating in writing and verbally, both clearly and directly
  • Bilingual in Cantonese  preferred but not required (any additional languages beneficial)

Education and Experience  

BSW or degree in behavioral or social sciences required. One to two years direct experience in case management and/or working in a social service setting required. Experience working with populations struggling with mental illness, substance abuse and poverty is strongly  preferred. A valid driver’s license, clean driving record and access to an automobile is desired.  Bi-lingual is Spanish, Cantonese, Vietnamese or Russian desirable. A valid driver’s license, clean driving record and access to an automobile is desired.

Work Environment

This position includes frequent travel to clients’ homes and also work in the office, at a desk in a temperature controlled office, in modular office space or an individual office. The noise level in the work environment is usually moderate. Frequent Travel: Must be able to travel on foot, via public transportation or personal vehicle to all parts of San Francisco for performance of job duties. May occasionally be exposed to outside weather conditions while traveling to clients’ homes. Some exposure to physical risk. Exposure to client apartments, rooms, homes and other venues so that services can be provided. May include contact with clients with mental health and/or personal hygiene issues.  

Physical Demands

The physical demands described here are representative of those that must be met by employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individual with disabilities to perform the essential functions. While performing the duties of the job, the employee is regularly required to talk or hear. The employee is frequently required to sit for extended periods of time at a desk or computer workstation. The employee is frequently require to stand, walk, sit, use hands to finger, handle, or feel, reach with hands and arms. The employee is occasionally required to climb or balance and stoop, kneel, or crouch. The employee may occasionally lift and/or move up to 15 pounds. Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.

How to Apply

Please send a resume and thoughtful cover letter including salary expectations to with “Service Coordinator II” as the subject. Applications without a cover letter will not be considered.

Homebridge is an equal opportunity, affirmative action employer committed to maintaining a non-discriminatory, diverse work environment.