EPD Waiver Case Manager (1099 Contractor)

PRESTIGE HEALTHCARE RESOURCES INC•Washington, DC

About The Position

As an EPD Waiver Case Manager, you will play a critical role in ensuring beneficiaries enrolled in the District of Columbia’s Elderly and Persons with Physical Disabilities (EPD) Medicaid Waiver Program receive comprehensive, coordinated, and person-centered services. Under the leadership of the Administrator of the EPD Case Management Department and supervision of the Case Manager Coordinator, you will maintain and update beneficiary electronic records using the DHCF electronic case management system, ensuring strict adherence to HIPAA and privacy laws. You will conduct comprehensive intake, annual recertification, and ongoing assessments of beneficiaries’ medical, social, and functional needs using a person-centered planning approach. You will facilitate care coordination meetings and develop comprehensive Person-Centered Service Plans (PCSPs) that reflect beneficiaries’ strengths, preferences, goals, resources, and assessed needs. You will provide ongoing case management and monthly monitoring, including required face-to-face home visits, supplemented by phone or email contact as needed. You will complete quarterly PCSP reviews, including risk assessments, service utilization monitoring, provider coordination, and goal progress evaluation. You will advocate for and connect beneficiaries to public benefits and community resources, including Medicaid, Medicare, SSI, housing, transportation, legal, and energy assistance. You will ensure beneficiaries remain connected to all eligible public benefits and supports. You will manage a caseload of up to 45 beneficiaries, based on acuity and level of support required. You will respond to crisis situations and participate in on-call coverage during evenings and weekends as required. You will perform all duties in alignment with PHRI’s mission, values, and regulatory requirements.

Requirements

A Bachelor’s degree (Master’s degree preferred).
One of the following licensure and experience combinations: Master’s degree with current licensure in nursing, social work, psychology, counseling, occupational, physical, or speech therapy, plus at least one (1) year of experience working with elderly individuals or persons with physical disabilities; or Bachelor’s degree with current licensure in one of the above disciplines, plus at least two (2) years of relevant experience; or Registered Nurse (RN) license with an Associate degree in nursing and at least three (3) years of experience working with elderly individuals and persons with physical disabilities.
Strong knowledge of case management principles, procedures, and best practices.
Excellent written, verbal, time management, and organizational skills.
Proficiency in web-based electronic documentation systems and Microsoft Office 365 (Outlook, Teams, Word, Excel), with the ability to learn new technologies.
Commitment to completing required DHCF core training and ongoing professional development.

Nice To Haves

Familiarity with the District of Columbia’s Home and Community-Based Services (HCBS) Medicaid Waiver for EPD populations.

Responsibilities

Maintain and update beneficiary electronic records using the DHCF electronic case management system, ensuring strict adherence to HIPAA and privacy laws.
Conduct comprehensive intake, annual recertification, and ongoing assessments of beneficiaries’ medical, social, and functional needs using a person-centered planning approach.
Facilitate care coordination meetings and develop comprehensive Person-Centered Service Plans (PCSPs) that reflect beneficiaries’ strengths, preferences, goals, resources, and assessed needs.
Provide ongoing case management and monthly monitoring, including required face-to-face home visits, supplemented by phone or email contact as needed.
Complete quarterly PCSP reviews, including risk assessments, service utilization monitoring, provider coordination, and goal progress evaluation.
Advocate for and connect beneficiaries to public benefits and community resources, including Medicaid, Medicare, SSI, housing, transportation, legal, and energy assistance.
Ensure beneficiaries remain connected to all eligible public benefits and supports.
Manage a caseload of up to 45 beneficiaries, based on acuity and level of support required.
Respond to crisis situations and participate in on-call coverage during evenings and weekends as required.
Perform all duties in alignment with PHRI’s mission, values, and regulatory requirements.