Case Manager

COLUMBUS MEDICAL SERVICES LLC• Remote, VT, US, VT

11d•$0 - $30•Hybrid

About The Position

The Case Manager coordinates application, referral, support planning, and monitoring processes in compliance with applicable policies and procedures and federal, state, and local standards. This is a hybrid, mobile position requiring regular travel in Windsor County and to different work locations. The Case Manager supports individuals receiving developmental disability (DS) and brain injury (BIP) services, helping them understand and lead individual-centered planning, identify and access appropriate services and community resources, and monitor whether services meet their needs and desired outcomes. The role includes facilitating assessments and annual reviews; preparing and maintaining individual service agreements and related documentation; coordinating provider matching and service authorizations; supporting self-direction when appropriate; monitoring service implementation, satisfaction, health, and well-being; responding to incidents; and assisting with redeterminations. The Case Manager documents service contacts and progress, submits required summaries and encounter data, and participates in state-required quality monitoring and reporting. Other duties related to care coordination may be assigned by the Case Manager Supervisor and State Program Administrator.

Requirements

Knowledge of Vermont’s public service system for developmental disabilities and brain injury services.
One of the following education and experience combinations: a bachelor’s degree in any field and one year of related human services experience; an associate degree in human services or a closely related field and two years of related human services experience; or a high school diploma and three years of related human services experience.
Related human services experience may include supporting individuals with disabilities or work in special education, sociology, vocational rehabilitation or employment, protection and advocacy, psychology, substance use, aging, healthcare, or social work.
Physical work base, either an office or home as determined by Columbus, must be in the county or within 60 miles or 60 minutes’ driving time of each caseload individual’s residence, subject to stated exceptions and approval requirements.
Ability to travel regularly to different work locations and work in typical local weather conditions; may need to stand or sit for long periods.
Proficiency in computer skills and ability to use Microsoft Office 365 applications.
Excellent written and verbal communication skills, including ability to write reports and correspondence and present information effectively.
Knowledge of planning principles and report preparation.
Ability to interpret policies and procedures; analyze situations and information; recommend courses of action; maintain effective relationships with employees and outside agencies; and define problems, collect data, establish facts, and draw valid conclusions.
Ability to pass a drug screen and background check before hire.
Commitment to ongoing training and self-improvement.

Responsibilities

Comply with agency policies and procedures and Vermont HCBS eligibility and enrollment requirements.
Support individuals in understanding and participating in assessment and individual-centered planning, including identifying preferences, strengths, goals, needs, and desired supports.
Schedule and facilitate planning and assessment activities, complete required needs assessment and annual review protocols, and prepare planning documents and agendas with the individual.
Help individuals invite chosen participants to planning meetings, lead the planning process, and distribute approved meeting documentation to the support team.
Coordinate completion of assessments and supporting documentation, and review and update individual service agreements and related documents at least annually.
Explain self-direction opportunities, rights and responsibilities, complaints, grievances, appeals, and service choices; provide accessible information and referrals to third-party assisters when needed or requested.
Help individuals identify and choose providers, self-direction options, and community resources; make referrals and provide follow-up assistance.
Collaborate with designated, specialized, and brain injury service agencies and regional providers to identify service availability, provider matches, and subcontracted services as applicable.
Coordinate implementation of service plans with individuals and their support teams, ensuring that stated needs, preferences, and outcomes are addressed.
Facilitate meetings with providers, subcontractors, self-directed employees, and other supports as needed to coordinate service delivery and address barriers.
Monitor service implementation, satisfaction, health, and well-being through visits, documentation reviews, and communication with individuals, guardians, families, and providers as applicable.
Review and respond to emergencies and incidents, validate that services align with plans, track progress toward outcomes, and arrange service changes when needed.
Support transitions to self-direction and assess whether an individual or surrogate can perform employer responsibilities; provide information about support brokering when appropriate.
For DS, complete contextual-factor screening as required, submit service authorization materials, initiate budget exception requests when appropriate, review quarterly utilization data, and arrange needs reassessments when required.
For BIP, upload needs assessments, service agreements, and authorization requests; request authorization changes when services do not meet needs; and track, prepare for, and submit reassessment materials.
Provide records and information for state or contracted-entity redeterminations and provide service choice counseling during reassessment and planning.
Write service notes for each date of service; document outcomes and progress using required summaries and case records; obtain QDDP approval of DS summaries; submit summaries on schedule and zero-paid encounter claims for reporting.
Participate in state-required quality monitoring and reporting, and advocate for continuity of services, community integration, accessibility, rights, and appropriate resource use.
Perform other duties related to coordination and execution of proper care as assigned by the Case Manager Supervisor and State Program Administrator.