ORGANIZATION

CoAction, founded in 1965, is your local Community Action Agency. From infancy to old age, we serve people experiencing financial hardship in Northwest Indiana. People experiencing financial hardship find opportunities, resources, and respect at CoAction. We envision the people of Northwest Indiana flourishing regardless of income, ability, or age. Serving residents in Lake, Porter, LaPorte, Jasper, Newton, Pulaski, and Starke Counties.

FUNCTION

Reporting to the Director of Home and Community-Based Services, the Veterans Directed Care Specialist coordinates and manages referrals for veterans enrolled in the Veterans Directed Care (VDC) program through multiple Veterans Affairs (VA) Medical Centers and affiliated clinics. This position serves as the primary liaison between the VA, veterans, caregivers, fiscal management entities, and community providers to facilitate person-centered planning, service coordination, and successful implementation of participant-directed care services. The Specialist ensures timely intake, assessment, enrollment, and ongoing care coordination for veterans seeking to remain safely in their homes and communities through the VDC model. This role supports compliance with Veterans Health Administration requirements, state and federal regulations, and organizational policies while promoting veteran choice, dignity, and independence.

MINIMUM QUALIFICATIONS

Bachelor's degree required in Social Work, Human Services, Psychology, Nursing, Public Administration, or related field; Master's preferred. Minimum 1-3 years experience in service planning, care coordination, or veteran services required. Experience working with veteran populations, healthcare systems, or participant-directed service models preferred. Knowledge of person-centered planning, long-term services and supports, and community resources preferred. Experience managing documentation, compliance requirements, and data reporting. Strong organizational skills with ability to manage multiple referrals and competing priorities. Excellent written, verbal, and interpersonal communication skills. Ability to establish collaborative relationships with veterans, caregivers, medical professionals, and community partners. Proficiency in electronic records systems and Microsoft Office applications. Valid driver's license and reliable transportation required.

PREFERRED QUALIFICATIONS

Knowledge of Veterans Health Administration programs, including Veterans Directed Care. Familiarity with fiscal management service models and participant-directed budgets. Bilingual skills a plus.

MAJOR DUTIES

Referral Coordination and Service Planning:

Receive, review, and process referrals from multiple VA hospitals, clinics, and care coordination teams. Conduct intake assessments and eligibility screening for Veterans Directed Care participation. Facilitate person-centered service planning with veterans, caregivers, and interdisciplinary partners. Coordinate enrollment processes, including development of spending plans and service authorizations. Monitor participant progress and maintain ongoing contact to ensure service effectiveness and veteran satisfaction. Support veterans in identifying needs, goals, risks, and supports to maximize independence and quality of life. Maintain timely follow-up and reassessment activities in accordance with program requirements.

Program Administration and Compliance:

Ensure compliance with Veterans Health Administration guidelines, state and federal regulations, and organizational policies. Maintain accurate case records, documentation, and reporting in required data systems. Track referral outcomes, service utilization, and performance measures to support quality assurance efforts. Prepare and submit required reports related to enrollment, service delivery, and program outcomes. Participate in audits, monitoring activities, and quality improvement initiatives. Identify barriers to access and recommend process improvements to improve referral efficiency and veteran engagement.

Collaboration and Partnership Development:

Serve as liaison between VA medical centers, community partners, fiscal management entities, and internal program staff. Develop and maintain strong working relationships with VA social workers, discharge planners, providers, and other stakeholders. Participate in interdisciplinary case conferences and care coordination meetings as needed. Promote effective transitions between hospital-based referrals and community-based service implementation. Provide education to veterans, families, and referral partners regarding the Veterans Directed Care model.

Veteran Advocacy and Support:

Advocate for veteran preferences, self-direction, and informed choice in care planning. Assist veterans and caregivers in navigating available community resources and support systems. Support crisis response and problem resolution related to service delivery concerns. Foster respectful, trauma-informed, and culturally competent interactions with veterans and their families.

Community Engagement:

Represent the organization in meetings, trainings, and outreach events related to veteran services. Support expansion of referral networks and community awareness of Veterans Directed Care services. Assist in building partnerships that enhance service capacity and improve veteran outcomes.

Other Duties:

Participate in regular staff meetings, training programs, and supervisory sessions to promote positive team relationships. Maintain current knowledge of veteran services, participant-directed models, and regulatory changes. Perform other duties as assigned by the Director of Home & Community-Based Services.