Case Manager

Job Summary An Advantage Case Manager is responsible to carry out the case management process as outlined by the case management standards of operation set forth by Oklahoma Department of Human Services MSU and directed under the supervision of CMS and/or Excell Private Care Services management team. Activities to include but not limited to: admission/intake, assessment/reassessment, services plan implementation, monitoring/evaluation, and discharge of members. The roles assumed by the case manager within the long‑term care services delivery system are services coordinator, member advocate, member consultant, good steward of state funds and gatekeeper. Responsibilities Establish intake, screening, and referral procedures for information requests about community long‑term care options and admitting only those consumers determined eligible by OKDHS. Review the comprehensive assessment and/or complete reassessment, as needed, to identify member needs, goals, abilities, resources, and support as the basis for service planning. Complete documentation and submit within specific timeframe. Orient and provide ongoing education to consumers as needed to empower them as informed and active members. Ensure coordination of available community resources and informal support, for which the member is eligible and/or has needs. Submit a comprehensive, written service plan for each member per the interdisciplinary team (IDT) process that establishes service goals, meets identified member needs, promotes independence, uses the most effective and cost‑efficient formal and informal resources, and clearly defines implementation responsibilities. Monitor the delivery of services and evaluate member outcomes and make revisions as indicated. Follow up on issues timely. Identify suspected abuse, neglect or exploitation and contact APS (Adult Protective Services) if necessary. Modify the service plan based on the status of the member without disruption of services or threat to the consumer’s health and safety. Use risk‑management mechanisms to address high‑risk situations and special needs of consumers. Submit documentation daily or as per supervisor direction. Review and monitor direct services provider emergency procedures to protect the health and safety of the member. Make appropriate referrals as needed. Collaborate with appropriate medical personnel regarding medically complex consumers. Ensure confidentiality according to all relevant laws and regulations and maintain HIPAA compliance. Maintain records to document activity in the performance of responsibility as a component of the service delivery system. Manage time with the fluctuation of member case load and receive/maintain all members as assigned. Participate in training of new case managers and serve as preceptor. Participate in all other job duties as requested and/or assigned by Case Management Supervisor or Back‑Up Supervisor. Review CQI audits received and update all findings within a 48‑hour period; if findings are substandard for CM job performance, the updates are non‑billable units. Participate in all training, in‑services and continuing education as required by Director of Operations, Case Management Supervisor or Educator as assigned. The employee may be requested to perform job‑related tasks other than those stated in this description. Job Requirements Minimum qualifications: RN with one year paid professional experience with aging or disabled population and Certified Advantage Case Manager; LPN with one year paid professional experience with aging or disabled population and Certified Advantage Case Manager; Baccalaureate degree with one year paid professional experience with aging or disabled population and performing duties which encompass the core functions of case management and a Certified Advantage Case Manager. Must be a licensed driver with a vehicle that is insured in accordance with state or organization requirements and in good working order. Speak fluent English and demonstrate excellent verbal and written communication skills. Demonstrate time‑management skills due to ever‑changing case load fluctuation and member needs with an emphasis on communication, collaboration, and interpersonal skills. Require intermediate computer skills using an office‑based word processing system. Working Environment Job requires working in hot, cold, or wet surroundings; outdoors, rarely in or near chemicals or radiation sources, with hazardous waste materials, wearing protective clothing/equipment, with exposure to blood and body fluids, and operating medical equipment. Local travel is required and must have access to reliable transportation. Physical Requirements Standing, walking, sitting, twisting, climbing, bending/reaching, driving, weights lifted or carried up to 10 pounds; weights pushed or pulled up to 10 pounds. Finger dexterity for writing and typing. Occasional driving for extended periods of time. Compensation The position is an exempt position. Compensation consists of a base salary plus a minimum number of units submitted based upon written notification by Case Management Supervisor or Director of Operations. Unbillable units submitted should not surpass 5% of total units submitted for the week without prior notification and approval. Equal Opportunity Statement We are an equal opportunity employer committed to ensuring that all conditions and privileges of employment, including recruitment, hiring, evaluation, transfer, promotion, discipline, determination of compensation and/or benefits, and termination of employment, for all job classifications, are based on qualifications and work record. No employment decision is made, nor do we discriminate, on the basis of race, color, religion, creed, sex/pregnancy, sexual orientation, gender identity, gender expression, age, national origin, ancestry, citizenship, veteran status, or disability. #J-18808-Ljbffr Deercreekseniorliving