Eligibility Specialist

About Us

Care Lync is a Social Services agency focused on hiring an Eligibility Specialist providing (Service Coordination/Case Management) services to adults diagnosed with Intellectual, Developmental and Physical Disabilities and Autism Spectrum Disorder throughout Pennsylvania who are enrolled in the Department of Human Services, Medicaid Waiver Program. Our Eligibility Specialist works with adults to help them to navigate, understand, and secure the services needed in order to live independently in their home and community.

We offer a great benefits package including medical, dental, vision, 401k, paid time off within a cooperative rewarding family environment.

General Summary

The Eligibility Specialist provides case management activities necessary to meet the needs of clients assigned to the consolidated care team. This position is responsible for the development of individualized care management plans; implementation of the care plan through brokering and coordinating services; and the monitoring and evaluation of all clinical outcomes to ensure that services are provided in a professional, comprehensive, and cost-effective manner. The role assists in the location, coordination and monitoring of needed services and supports through the development and implementation of the Individual Support Plan (ISP). The Eligibility Specialist will assist the person(s) receiving services in identifying and communicating his/her requests and needs for services and supports, which may include housing, medical, social, vocational and other community services.

Essential Duties and Responsibilities

Complete assessments to assist in identifying each participant needs and desires for service delivery.

Develops a Person-Centered Service Plan for each participant and modify at least annually or when there is a significant medical or social change.

Ensure the participant choice of providers by providing information for the participant to make a fully informed decision.

Ensure the Behavioral Support Plan and Crisis Plan (if the participant has a Behavior Specialist) is consistent with the ISP.

Report all incidents of participant abuse, neglect or exploitation immediately to supervisor/director.

Actively coordinate with other individuals and/or entities essential in the physical and/or behavioral care delivery for the participant, including other care coordinators, to ensure seamless coordination between physical, behavioral and support services.

Responsible for researching and developing alternative solutions to participants needs.

Ensures confidentiality regarding sensitive material and private health information of each individual served.

Attends required trainings and recertification classes.

Confers regularly with supervisor/ director(s) to understand and consider factors such as participants needs, abilities, learning levels, and physical limitations.

50% travel to participants as needed

Qualifications

BS/BA degree in related course work

Experience with Microsoft Office, state-maintained databases.

Must maintain proficiency in company sponsored training and certifications.

Maintain CPR/First Aid certification and updated state related Clearances.

Successfully complete and maintain training courses as required or amended by program regulations.

Valid Driver's License including personal vehicle insurance coverage for liability and current vehicle registration, copies must be maintained on file with Care Lync.

* Please specify if you are bi-lingual (English-Spanish).

Care Lync is an equal opportunity employer and complies with the provisions of the Federal Civil Rights Act of 1964 and the Pennsylvania Human Relations Act of 1955 and all requirements imposed pursuant thereto. No person shall, on the grounds of race, color, national origin, ancestry, age, sex, religious creed, or disability, be excluded from participation in, be denied benefits of, or otherwise be subject to discrimination in the provision of any hiring opportunities, care or services. Care Lync will not, directly or through contractual arrangements discriminate its patients, consumers, employees, partners, 3rd party vendors or any person on the basis of race, color, national origin, ancestry, age, sex, religious creed, disability, sexual identification or any other category protected under law. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, religious creed, sexual orientation, ancestry, gender identity, national origin, protected veteran status, disability status, sexual identification or any other characteristic protected by applicable law.