Case Manager

The case manager is responsible for the follow-up with the person receiving ADW services to ensure that services are being provided as described in the Service Plan

Description:

• Assures financial eligibility remains current
  Submits the MNER in accordance with policy
  Addresses changing needs of the person as reported
  Addresses changing needs determined by monthly contact
  Refers and procures any additional services or resources needed
  Coordinates with all current service providers to develop the six-month Service Plan and the Annual Service Plan (or more often as necessary)Be present at the six-month service plan meeting and the annual service plan meeting
  Provides the service plan to all applicable service providers including TMH Transition navigators that are providing services to the person
  Provides copies of all necessary document to the person receiving ADW services
  Annually submits a medical necessity evaluation request to the UMC
  Submits WV personal care request for dual services as needed
  Uploads documents into the UMC web portal
  Assists with filling grievances, complaints, fair hearing request
  Makes fraud and abuse/neglect referrals as needed
  Assists with obtaining legal representation when needed, such as medical power of attorney, health care surrogate, etc.
  Ensures services were provided in accordance with the service plan
  Evaluates social, environmental, services, risks, and support needs of the individual
  Develops and writes an individualized service plan which details all services that are to be provided including both formal and informal services that will assist the person to achieve optimum function
  Coordinates the delivery of care, eliminate fragmentation of services, and assure appropriate use of resources
  Proactively identifies problems and coordinate services that provide appropriate high-quality care to meet the individualized and often complex needs of the person
  Provides advocacy on behalf of the person to ensure continuity of services, system flexibility, integrated services, proper utilization of facilities and resources, and accessibility to services
  Ensures that a person's wishes are preferences are reflected in development of service plan by working directly with the person and all service providers
  Assures that a person's legal and human rights are protected
  Follows up on all service deliver concerns and document in WV IMS
  Completes and submits all required administrative and program reports as requested by either BMS or the QS

Qualifications:

• Bachelor's degree in the Human Service field
  Two years of experience with case management or related discipline
  Licensed in West Virginia as a Social Worker or Counselor
  Ability to operate standard computer and communications equipment
  Working knowledge and use of MS Word, Excel, and other software related to job functions
  Knowledge of agency intake/placement procedures and guidelines, necessary forms and standard intake procedures
  Ability to composing correspondence and basic office etiquette and procedures
  Ability to be flexible and meet deadlines
  Ability to handle multiple tasks in an orderly and timely manner
  Ability to coordinate and maintain client files and agency forms
  Wiling to travel as needed

Benefits

• Medical insurance
• 401k