Case Manager (Prince William/Fredericksburg)

Brain Injury Services (BIS) seeks a full-time Brain Injury Case Manager to serve our clients. We are seeking case managers with a strong background in case management and at least 2 years of experience . Preferences will be given to candidates who have experience navigating Medicaid referrals, submitting service authorizations, monitoring billing, and collaborating with Managed Care Organizations (MCOs) in the Targeted Case Management (TCM) services for BIS clients.

Position Service area:

Prince William County/Fredericksburg

Definition:

Under the supervision of the Senior Manager of Case Management Services, the Case Manager provides community-based case management to adults and children with acquired brain injury and their families in the Northern Virginia region. The adult brain injury program includes long-term case management services and public awareness. These services are provided using a community-based case management model.

Distinguishing Characteristics:

This position requires a professional level of intervention with complex cases. The Case Manager position assumes the ability to work independently and exercise autonomy. The Department Manager may designate other duties. This position is guided by the mission of this organization to support individuals with brain injuries and their families in reaching their maximal level of functioning within their communities using a person-centered approach.

Essential Job Functions and Responsibilities

• Adhere to professional standards, federal and local requirements, and MCO regulations to serve and protect the agency.
• Obtain information and make referrals for appropriate services, including TCM-related referrals and general referrals to community services.
• Do a comprehensive intake evaluation, including completing all documentation designated in the Policy and Procedure Manual, and obtaining all necessary medical records from outside sources to ensure a thorough review and service eligibility.
• Complete all required paperwork for Medicaid TCM services, including service authorizations, assessments, evaluation, review, billing, and reporting.
• Complete a thorough client assessment, which includes the client’s strengths and weaknesses, family and community support systems, a Needs assessment that covers all areas described in the Adult Brain Injury Case Management Policy and Procedure Manual, and the assessment of existing resources presently utilized by the client and gaps in service’s requiring intervention within 45 days of opening a case.
• Obtains appropriate releases, understands the laws regarding confidentiality, and upholds these laws.
• Provide education and awareness to the public on prevention, identifying children and adolescents with brain injury, and the support needed to transition students back to school successfully, and children back into their home community.
• Travel and provide services in clients' homes and communities. This includes participating in the discharge planning teams, when possible, at children’s facilities and rehabilitation centers nearby (e.g., Cumberland Hospital in New Kent, Kluge Children’s Rehab Center in Charlottesville, NRH’s Pediatric Program in Washington, Kennedy-Krieger Institute in Baltimore).
• Determine when the maximal level of functioning has been achieved and outside services, such as life skills training/tutoring, need to fade.
• Completes all paperwork as described in the Policy and Procedure Manual and always maintains charts orderly.
• Establish a solid therapeutic relationship with clients, their families, and their community providers.
• Supports clients in developing their own goals and plans based on the needs assessment and utilizing various planning tools. Completes an Individualized Service Plan and provides a written copy to the client.
• Review the ISP every 90 and adhere to the MCO’s rules and regulations about service review. Clients’ signatures are required to ensure the client’s consent and participation in services.
• Identify, coordinate, and monitor goal-directed community services to meet the client’s needs and desired activities as outlined in their plans.
• Maintain in-person and/or virtual contact with active clients and/or families at least monthly and quarterly contact with follow-along clients. Contact is made to offer support, and guidance, and assist them in maximizing the clients’ participation in the goal-attainment process.
• Effectively negotiate for services for clients in their communities professionally.
• Travel and provide services in client’s homes and communities
• Maintain a confidential home environment equipped with a reliable internet connection to facilitate remote workdays; otherwise, working from the office will always be required.
• Full-time staff should maintain a caseload of up to 30 active clients and no more than 15 follow-along clients. Full-time staff with reduced working hours (30, 32, 35 hrs/week) will carry a caseload of up to 26 active clients. Part-time staff (20 hrs or less) will have a caseload of up to 20 clients.
• Understand the Vendor Contract budget and prioritize service payments based on need, financial eligibility, and resource availability.
• Understand the Vendor Contract for the various MCOs and the different requirements of each
• Provide education to clients, their families, and the community regarding brain injury and community resources.
• Demonstrate a commitment to person-centered services and the opportunity for clients to choose their services and providers as documented in the individualized service plan and case notes.
• Spend at least 50% of their time in direct contact with clients and their families, providing supportive counseling, coordination of services, resource determination, monitoring of services, and team meetings. This will be monitored through case documentation and Outlook calendar entries.
• Professionally present themselves in dress, language, questions, and comments.
• Maintain a routine schedule, which reflects a 40-hour week but is flexible to include evening meetings. This is also monitored through the Outlook Calendar entries
• Participate in professional training, particularly in the brain injury field, and additional training as directed by the supervisor.
• Attend and participate in all Case Management Department meetings, Staff Professional Trainings, staff meetings, and regular one-on-one supervision with the department manager
• Other duties as directed by the Department Manager of Case Management Services.

Requirements

Knowledge, Skills, and Abilities

• Integrity, discretion, and respect for confidentiality and privacy
• Good knowledge of Brain injury and its effects on individuals and families
• Self-directed, able to work independently with a high level of autonomy and strong problem-solving skills
• Knowledge of ADA and IDEA as well as special education
• knowledge of Long-Term Case Management
• Knowledge of the Veterans Affairs system
• Knowledge of the Medicaid system and MCOs
• Knowledge of supportive counseling techniques
• Knowledge of basic medical terminology
• Knowledge of community agencies/resources.
• Excellent oral and written communication skills and the ability to de-escalate misunderstanding errors in a professional manner
• Strong technology and computer skills, e.g., typing, computing, data entry, virtual video platforms (e.g., Zoom), DocuSign, and other technical skills as the job requires
• Strong assessment and analytical skills
• Ability to prioritize work under pressure
• Strong time management skills
• Strong organizational skills
• Strong attention to detail
• Strong spelling, math, and financial skills
• Strong documentation skills on time

Essential Job Requirements

• Valid driver’s license and reliable personal transportation to travel throughout Fairfax, Arlington, City of Alexandria, Loudoun, and Prince William areas. Local travel is required
• Act as the point of contact for TCM referrals
• Physical mobility
• Ability to perform math calculations
• Ability to perform complex problem-solving and reasoning.
• Ability to secure a telework environment at home that maintains confidentiality and professionalism
• Access to secure and reliable internet services at home for the remote work option
• Ability to shift between in-person and virtual service delivery models.
• Must be able to read, write, and proofread professionally.

Educational Requirements

• Master's Degree in the human service field, e.g., Social Work, Rehab Counseling, Psychology, Occupational Therapy, etc.
• Brain Injury Fundamental Training and Qualified Brain Injury Specialist training are required upon hiring.
• Certified Brain Injury Specialist training is optional after 1 year of hiring.

Preferred

Bilingual in any of the following languages: Spanish, Arabic, Korean, and Vietnamese