Case Manager

About the Job

Waiver Case Manager Position Description :

Class Characteristics: Under general direction, provides Services Advisor/Case Management services and person centered care planning for participants in the Medicaid Home and Community Based Waiver (HCBW) Participant Directed Services (PDS), Blended and traditional services; and Michelle P Waiver (MPW) Program, Participant Directed Services and blended in the Barren River region; serves as liaison between the participant, DAIL and Medicaid; performs related duties as required.

General Duties and Responsibilities:

Essential:

• Advise a participant regarding any aspect of PDS, traditional or blended services and facilitate access to services.
• Continually monitor a participant's health, safety, and welfare and provide information on how to access resources.
• Participate in a Person Centered Plan of Care.
• Organize team meetings.
• Coordinate the completion of level of care recertification annually by working with the independent assessor and develop a person-centered service plan with the participant and any member of the participant's person-centered team.
• Monitor services to ensure services are provided according to the Plan of Care.
• Maintain a good working relationship with service providers and serve as a source of review for planners and administrators.
• Maintain complete, accurate, and timely client records and continuously work within the social service system for the benefit of all functionally impaired older people and disabled individuals.
• Assist participants with Medicaid eligibility.
• Assist participants with obtaining appropriate authorizations to begin services through various avenues such as Medicaid, Department for Aging and Independent Living (DAIL), Quality Improvement Organization (QIO) and Hewitt Packard (HP), and Department of Community Bases Services.
• Train employers and Care givers regarding PDS services and timesheet guidelines.
• Review employee timesheets for PDS.
• Monitors satisfaction of the quality of service provided.
• Performs other duties as assigned.

DESIRED QUALIFICATIONS:

Training and Experience: A Bachelor's Degree in a Health or Human Services field from an accredited college or university with a minimum of one (1) year of experience in a Health or Human Services field or the educational or experimental equivalent in the field of aging or disabilities; or a Registered Nurse with at least two (2) years of experience as a professional nurse in the field of aging or disabilities; or a Master's degree in a Health or Human Services field from an accredited college or university.

Special Knowledge, Skills and Abilities:

Knowledge:

• Thorough knowledge of federal and state programs and program guidelines for the elderly and disabled.
• Thorough knowledge of administrative requirements for programs involving the elderly and disabled.
• Thorough knowledge of the social and economic conditions of the region.
• Thorough knowledge of Service Advisor policies and procedures as regulated by DAIL.
• Knowledge of both formal and informal resources available for the elderly and disabled.
• Thorough knowledge of human behavior.
• Thorough knowledge of community organizations and service system development.
• Thorough knowledge and skill in social and health service intervention techniques and methodology.

Skills:

• Skilled to assess and incorporate available resources.
• Skilled in oral and written communication.
• Skilled in the preparation of detailed reports and plans.
• Skilled in strong interpersonal skills relating to the elderly and to subcontractors.
• Skilled at using the computerized data system and basic office equipment.

Abilities:

• Ability to recognize the weakness and strengths and to provide continuous care for participating clients.
• Must be able to perform all in-home visits and document case notes and other required documents on a laptop or desktop computer.
• Ability to coordinate and communicate well with clients, service providers, the general public and other staff members.
• Ability to maintain composure under stressful situations.
• Ability to be flexible in an ever-changing environment.
• Ability to prepare and maintain accurate records.
• Ability to work independently.
• Ability to establish and maintain effective working relationships with co-workers, state and local officials and administrative personnel, clients, and the general public.

ADDITIONAL REQUIREMENTS:

• Instructions: Instructions are somewhat general; many aspects of work covered specifically, but requires some use of own judgment.
• Processes: Frequently required to refine existing work methods and develop new techniques, concepts, or programs within established limits or policies.
• Review of Work: Supervisor will spot check work as it is being completed and work is reviewed upon completion.
• Analytical Requirements: Work frequently involves decisions based on knowledge of many factors where application of advanced or technical concepts is predominantly required.
• Decisions and Judgments: Position requires the ability to determine needs and the availability of resources.
• Physical Demands: Work is typically performed indoors at a desk or table; intermittently sitting, standing or stooping; must lift light object (less than 25 pounds); work is occasionally performed outdoors; must operate a vehicle or other equipment as a requirement of the job.
• Tools and/or Equipment Used: Basic office equipment (computer, copier, telephone, fax machine, etc.); must operate a vehicle as a job requirement.
• Contacts: Frequent public and internal contacts requiring tact and diplomacy.
• Confidential Information: Regular use of confidential information.
• Mental Effort: Heavy.
• Interruptions: Frequent.
• Availability: The Service Advisor must be available 24 hours a day, 7 days a week.
• Special Licensing / Certification Requirements: Must possess and maintain a valid driver's license. Also see desired qualifications. Must attend regularly scheduled training to maintain certification. Registered Nurses must maintain a valid license as a condition of continued employment.
• Additional Requirements: Negative TB skin test, proof of vehicle insurance, pass criminal background checks and drug test. Overnight travel as needed.

Overtime Provision: Exempt

BRADD Mission Statement:

The mission of the Barren River Area Development District is to preserve and advance the quality of life and economic well-being for all citizens of the BRADD through regional collaboration.

*The above job description is intended to describe the general content of and the requirements for the performance of this job. It is not intended to be construed as an exhaustive statement of duties, requirements or responsibilities.