The Gateway Area Development District is seeking a qualified individual for a full-time Case Manager for the Medicaid Home and Community Based (HCB) Waiver Program. This individual will be responsible for the development and monitoring of clients’ budgets and service plans to maintain clients’ services in the community. Responsibilities also involve clinical case management activities, including the development and management of care plans, periodic in-home face-to-face contacts with clients, general case management, documentation, and financial oversight of developed care plans. This position works closely with community resources and Medicaid offices in determining program eligibility for the client base. Populations served are individuals with physical, intellectual, and developmental disabilities ranging in age from young children to older adults.
General Duties and Responsibilities
1. Participant Directed Services (PDS) and Traditional Waiver Case Management: Involves developing and maintaining a Plan of Care for PDS and Traditional Waiver clients, completing required home visits and telephone calls, and data entry. This duty will consist of:
Conduct face-to-face visits every month with PDS clients and every other month with Traditional Waiver clients;
Contact Traditional Waiver clients during the months that face-to-face visits are not performed;
Data entry and case notes in the Medicaid Waiver Management Application (MWMA);
Ensure services are being provided in accordance with the client’s person-centered service plan;
Work with Medicaid providers to ensure services are being provided in accordance with the Plan of Care;
File maintenance and documentation;
Develop, maintain, modify, and review a Plan of Care for each client;
Assist the client in collecting new PDS employee paperwork, including withholding documentation, eligibility verification, and employees/client contract;
Track PDS employee background checks, trainings, certifications, and other program requirements (i.e., Tuberculin (TB) skin tests, CPR/First Aid certification, attendant care training);
Issue a corrective action plan when the Plan of Care is not being followed or when there is a threat to the health, safety, and welfare of the client;
Terminate clients from the program when the program cannot sufficiently meet the client’s requirements, when imminent threats exist to the client, when a client or representative refuses to follow the corrective action plan, or when services are utilized within 60 days;
Review PDS employee timesheets for completeness, compliance with the Plan of Care, calculation errors, service documentation, and signature;
Evaluate the client’s expenditures and balance of services available at each monthly face-to-face visit; and
Conduct eligibility checks at the beginning of each month to verify that each client is Medicaid eligible and remains active.
2. Other Duties: Involves any other tasks and assistance needed to support the Aging & Independent Living Department.
Sit for extended periods of time; stand and walk for extended periods of time; reach, stoop, crouch, bend; ability to lift and carry approximately 30 pounds; fine motor skills; and operate a vehicle.
Knowledge, Skills, and Abilities
Federal and state programs and guidelines for the elderly and disabled;
Record keeping and reporting requirements;
Waiver policies and procedures as regulated by the Department for Aging and Independent Living and the Department for Medicaid Services;
Formal and informal resources available for the elderly and disabled; and
Non-profit operations, organizations, functions, and challenges.
Oral and written communication;
Microsoft Office Suite (Word, PowerPoint, Excel);
Attention to detail;
Use of computers and other office equipment;
Reasoning, problem-solving, and organization;
Establishing and sustaining interpersonal relationships; and
Organizing and maintaining accurate files and records.
Be present and punctual;
Prioritize work and meet deadlines;
Work under stressful situations with patience and tact;
Administer federal and state-funded programs;
Identify workload, be flexible, and prioritize changing workloads;
Prepare and maintain accurate records;
Establish and maintain effective working relationships with funding agencies, contractors, officer, and employees of the organization; and
This position will remain open until filled.
Gateway Area Development District is an Equal Opportunity Employer M/F/D/V.Minimum Qualifications
Applicants must have a Bachelor’s degree in a health or human services field (Social Work, Counseling, etc.) from an accredited college or university; and at least one (1) year of experience in a health or human services field; or the educational or experiential equivalent in the field of aging or disabilities; or be a registered nurse who has at least two (2) years of experience as a professional nurse in the field of aging or disabilities; or have a master’s degree in a health or human services field from an accredited college or university. Applicants with an Associate’s degree in a health or human services field with at least one (1) year of field experience may also be considered.
Must possess a valid driver’s license.
As a condition of employment, the successful applicant must:
• Pass a drug test.
• Pass multiple background checks.
• Complete a tuberculosis (TB) risk assessment performed by a licensed medical professional within the past twelve (12) months and annually thereafter.
• Receive and maintain cardiopulmonary resuscitation certification and first aid certification provided by a nationally accredited entity within six (6) months of employment.
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