Eligibility Specialist - Spartanburg, SC

Care Lync•Spartanburg, SC

17h

About The Position

The Eligibility Specialist / Case Manager provides case management activities to meet the needs of clients assigned to the consolidated care team. The role develops individualized care management plans; implements those plans by brokering and coordinating services; and monitors and evaluates clinical outcomes to help ensure services are professional, comprehensive, and cost-effective. The specialist assists in locating, coordinating, and monitoring services and supports through development and implementation of the Individual Support Plan (ISP). They help people receiving services identify and communicate requests and needs for housing, medical, social, vocational, and other community services. Care Lync is a social services agency providing Support Coordination services to adults with intellectual, developmental, or physical disabilities and autism spectrum disorder who are enrolled in the Department of Human Services Medicaid Waiver Program. Support Coordinators help adults navigate, understand, and secure services that support independent living in their homes and communities.

Requirements

Bachelor of Science or Bachelor of Arts degree in related coursework.
Experience with Microsoft Office and state-maintained databases.
Maintain proficiency in company-sponsored training and certifications.
Maintain CPR/First Aid certification and current state-related clearances.
Successfully complete and maintain training courses required or amended by program regulations.
Valid driver’s license, personal vehicle insurance coverage for liability, and current vehicle registration; copies must be maintained on file with Care Lync.
Immediately inform a supervisor of any change in auto insurance agency or policy, automobile registration, or driver’s-license status.

Responsibilities

Complete assessments to identify each participant’s needs and service-delivery preferences.
Develop a Person-Centered Service Plan for each participant and modify it at least annually or when a significant medical or social change occurs.
Provide information so participants can make fully informed choices of providers.
Ensure the Behavioral Support Plan and Crisis Plan, when the participant has a Behavior Specialist, are consistent with the ISP.
Immediately report participant abuse, neglect, or exploitation to a supervisor or director.
Coordinate with individuals and entities involved in participants’ physical or behavioral care, including other care coordinators, to support seamless coordination of physical, behavioral, and support services.
Research and develop alternative solutions to participants’ needs.
Maintain confidentiality of sensitive material and individuals’ private health information.
Attend required trainings and recertification classes.
Confer regularly with supervisors and directors about participants’ needs, abilities, learning levels, and physical limitations.
Travel to participants as needed; the posting states travel is 50%.