Case Manager (RN or Social Worker)

Job Description

Job Description

Provide case management services to EPD Waiver beneficiaries in their homes in accordance with the EPD Waiver regulations in the District of Columbia, and under the direction and supervision of the Clinical Director or another appropriate supervisor. Ensure that all required visits and assessments are completed and submitted timely.

Responsibilities 

• Provide ongoing direct observation of the beneficiaries, maintain contact with the recipient’s Authorized Representative (AR) as needed, and conduct comprehensive assessments of the beneficiary’s medical, social, and functional status including requests for Level of Care (LOC) assessments and financial eligibility documentation.

• Ensure that all required visits and assessments are completed and submitted timely. 

• Provide ongoing direct observation of the beneficiaries, maintain contact with the recipient’s Authorized Representative (AR) as needed, and conduct comprehensive assessments of the beneficiary’s medical, social, and functional status including requests for Level of Care (LOC) assessments and financial eligibility documentation.

• Develop, present to the recipient /AR for acceptance, and implement the Person-Centered Service Plan (PCSP) for the beneficiary, including the goals, service providers, frequency, and duration of services as per the current EPD Waiver regulations and guidelines.

• Observe, record, and report changes in the beneficiary's emotional and social factors that affect the client's illness and his/her need for EPD Waiver Services, and his/her response to services.

• Consult with and contact the attending physician concerning changes in the Level of Care (LOC) and Change in Condition requests as needed.

• Review and respond to all “TASKS” directed to the Case Manager in a timely fashion, and ensure the resolution of concerns expeditiously.

• Maintain and submit clinical records as required by DHCF, including the assessments, communication notes, monthly visit notes, quarterly reviews, and other documents and assessments.

• Evaluate the beneficiary and family's response to, and effectiveness of, the EPD Waiver services being rendered to the beneficiary.

• Assist in the admission process of the beneficiary to the agency by performing an evaluation, assessing the client’s psychosocial status, and evaluating the beneficiary, family, and home to identify socioeconomic and emotional factors that will affect the services that the beneficiary can use to continue to live in the community.

• Participate in agency meetings, activities, and committees when appropriate to include staff development activities and in-service education.

• Supervise the Case Manager Assistant/Aide, when applicable.

• Provide community resource planning and crisis intervention. Provide referral to community resources, maintain communication with other providers regarding the recipient’s progress and goals, coordinate with multiple providers, and assess the appropriateness for participation in the program on an ongoing basis.

• Assume responsibility for self-development by continually striving to improve his/her Social Worker or RN practice through formal education, attendance at workshops and conferences, active participation in professional and related organizational meetings, and individual research and reading.

Case Management Services

• Assess the beneficiary's potential to cope with his/her social and health problems in the community with the support system and services.

• Knowledge of EPD Waiver regulations and resources available in the community for EPD Waiver Beneficiaries

• Act as a consultant to the members of the health team, assisting them in understanding the social, emotional, and environmental factors related to the client's health problems.

• Help clients to utilize the resources of their families and the community.

• Assist clients and their families in coping with personal and environmental difficulties which might predispose them toward illness or interfere with obtaining maximum benefits from medical care.

Job Conditions 

• The ability to communicate effectively, both verbally and in writing in English is required

• The ability to access clients’ homes which may not be routinely wheelchair accessible is required.

• Hearing, eyesight and physical dexterity must be sufficient to perform a physical assessment of the client's condition and to perform client care.

• Physical activities will include, walking, sitting, stooping, and standing

Equipment Operation 

• Utilization of calculator, multi-line telephone, copy machine, and hand washing materials

Qualifications

• Licensed Social Worker (LGSW or LCSW) or Registered Nurse (RN) in the District of Columbia

• Two years of professional experience preferred, with at least one year of experience in home care

• Must have current CPR certification.