CMA Case Manager- Pagosa Springs

Job Description

Job Description

Are you interested in making a meaningful difference in the lives of people with disabilities or related health challenges in our community? 

Community Connections, Inc. is looking for a Full-Time Case Manager to support people with disabilities in our community who are on Long-Term Care Medicaid.  This is a hybrid position and will be based out of our Pagosa Springs office. Full benefits, including unlimited PTO, and flexible schedule. Wage is $25.49/hour.  Must hold a bachelor’s degree; or Five (5) years of relevant experience in the field of LTSS, which includes individuals with Disabilities; or some combination of education and relevant experience appropriate to the requirements of the position. 

Full-Time benefits include medical insurance available for purchase with employer contribution; dental and vision available for purchase; life insurance paid by employer; 401K participation after 12 months of employment and 1,000 hours worked within those 12 months; Aflac and LegalShield available for purchase; paid company holidays; Employee Assistance Program (EAP); unlimited PTO. Accepting submissions until 5 pm on 10/06/2026. EOE.

Title: CMA Case Manager

Reports To: Case Management Program Manager or other designated manager

FLSA: Hourly/Non-exempt Full-Time

Location: Hybrid position based out of Pagosa Springs, CO

Hourly Rate: $25.49

Summary of Position:

Provide case management and coordinate services for individuals served through Medicaid waiver programs, State General fund programs, and other programs administered by the Case Management Agency. Caseloads are generally assigned geographically and by area of expertise, although specific caseload assignments are the prerogative of the Vice President of Case Management to meet the needs of the organization and the people we serve.

Case Managers specializing in intake will serve as the first point of contact for individuals and agencies inquiring about services and supports offered by the CMA; completing intakes, screenings and referrals; facilitating all intake meetings; completing developmental disability and delay determinations; providing and coordinating the delivery of case management services, determining eligibility for Medicaid Waiver and program services. Not every employee will always perform every listed duty. Case Managers may be trained and assigned duties within the scope of the position based on qualifications, program requirements, coverage needs, workload, and organizational needs.

Work Schedule: This is a full-time, non-exempt position generally scheduled for five workdays per week. Workdays and hours may vary based on departmental responsibilities, meetings, travel, coverage needs, deadlines, and service needs. Alternative schedules require supervisory approval. The position may be eligible for a combination of onsite and remote work with supervisory approval. Hybrid work is not guaranteed and may be modified or discontinued based on service needs, employee performance, coverage, confidentiality, technology, or organizational requirements.

Essential Duties and Responsibilities:

Depending on assignment, essential functions may include the following. Not every Case Manager will perform every function at all times.

• Provide assistance with intake and referrals.
• Determine eligibility for all Medicaid Waiver services and State General Fund applicants.
• Create Person-Centered service plans to support the health, safety, and well-being of individuals in services.
• Monitor services established in the Service Plan to ensure that services meet the intent, scope, frequency, and duration documented.
• Serve the public interest in ensuring that all services are provided in accordance with Colorado Medicaid and Department of Human Services Rules and Regulations.
• Demonstrate knowledge of local resources and refer individuals and families to third-party and community resources as appropriate.
• Assist individuals and families in identifying, understanding, and accessing available community, state, and federal resources.
• Collaborate, as authorized and appropriate, with healthcare providers, service providers, schools, agencies, community partners, and other members of the individual’s support team.
• Prepare and maintain written case records, reports and forms as well as inputting client information into the state case management system and CCI developed systems.
• Assure the timely submission of required documentation to Colorado Health Care Policy and Finance (HCPF).
• Cooperate fully with monitoring by HCPF and the Federal Centers for Medicare and Medicaid Services (CMS) and other governmental or private entities assigned to confirm program quality.
• Comply with all local agency Policies and Procedures.
• Interact in a professional, supportive, and compassionate manner with all persons in services, families and community members.
• Advocate for the needs of people with disabilities within our local communities.
• Serve as a mentor for newer employees and allow shadowing of current workload.
• Be available to make home visits for assessments and in- home monitoring.
• Regular and dependable attendance.
• Complete all intakes, screening and referrals and assign a case manager to complete the functional eligibility assessment and individualized plan.
• Complete developmental disability and developmental delay determinations in accordance with regulations.
• Complete intake meetings post-determination and upon request to explain the service delivery options and enrollment steps.
• Keep record of all communications in state prescribed system.
• Create consumer record and enter developmental disability and developmental delay determinations into state prescribed system, including DD Waiver waitlist.
• Create client folder, collect all supporting documentation required for enrollment and save it in the client folder.
• Maintain current intake and enrollment spreadsheets and case assignment list.
• Provide due process and appeal rights to individuals, guardians and authorized representatives as appropriate.
• Complete new enrollments, transfers and transitions into adult Waiver and State SLS services.
• Represent the organization at intake-related partner agency meetings and outreach events.
• Provide ongoing education and outreach to referral agencies in order to streamline the referral and intake process.
• All reasonable duties as assigned by VP of Case Management or the President/CEO.

Core Competencies:

• Compassion and cultural responsiveness
• Organizational agility and adaptability
• Listening
• Motivating others and collaborating well in a team setting
• Organizational agility
• Patience
• Time Management
• Use of resources and sound judgement
• Person-Centered Communication

Knowledge and Abilities:

• Customer services abilities with both written and oral communication skills
• Ability to prioritize
• Assess situations accurately and problem solve efficiently
• Strong computer skills and use of technology to increase efficiency
• Maintain regular and dependable attendance and punctuality in accordance with the requirements of the position and organizational policy
• Observes both safety and security procedures
• Follow Health Insurance Portability and Accountability Act
• Ability to travel throughout the assigned service area and to other locations as required. Employees who drive on organizational business must maintain a valid driver’s license and automobile insurance consistent with organizational policy.

Employment is contingent upon satisfactory completion of job-related background and reference checks, which may include a motor vehicle record review. Results will be evaluated in accordance with applicable law and organizational policy.

Required Qualifications:

• Must hold a bachelor’s degree; or
• Five (5) years of relevant experience in the field of LTSS, which includes Developmental Disabilities; or
• Some combination of education and relevant experience appropriate to the requirements of the position. Relevant experience is defined as:

1.     Experience in one of the following areas: long-term care services and supports, gerontology, physical rehabilitation, disability services, children with special health care needs, behavioral science, special education, public health or nonprofit administration, or health/medical services, including working directly with persons with physical, intellectual or developmental disabilities, mental illness, or other vulnerable populations as appropriate to the position being filled; and,

2.     Completed coursework and/or experience related to the type of administrative duties performed by case managers may qualify for up to two (2) years of required relevant experience.

Preferred Qualifications:

Two or more years of experience working in developmental disability services, long-term services and supports, or a related case management setting is preferred.

Work Environment, Travel, and Physical Requirements: These essential tasks may be performed with or without accommodation or assistive technology. Employees in this position may spend significant hours on the computer writing and corresponding. The position requires reviewing information in electronic and paper formats and communicating effectively through electronic, written, telephone, virtual, and in-person methods, with or without reasonable accommodation. An employee in this position will use a laptop computer and may also have documents and files that they will need to transport within and outside the office. The employee will be required to perform home visits and attend meetings, training, and other community activities within the region of Southwest Colorado, with the possibility of occasional travel within Colorado or out of state to training or conferences.