Home Modification Specialist

CareStar, Inc.•Cincinnati, OH

6d•Remote

About The Position

Founded in 1988 in Cincinnati, Ohio, CareStar, Inc. is a recognized leader in long-term care case management and population health. With a mission to Improve Communities by Improving Lives, we proudly serve individuals across Ohio through compassionate, high-quality care coordination. We are currently seeking a Home Modification Specialist to join our Ohio Home Care program. This is a meaningful opportunity for professionals who are passionate about helping others live healthier, more independent lives. As a Home Modification Specialist, you will receive, review and process all requests for home modifications. The Home Modification Specialist will also assist with processing requests for adaptive/assistive devices and durable medical equipment. You will review requests to assess if program criteria are met.

Requirements

Bachelor’s degree in Social Work, Counseling, Psychology, Nursing, or a related field
Licensed Social Worker (LSW), Licensed Independent Social Worker (LISW), Licensed Practical Nurse (LPN) or Registered Nurse (RN)
Minimum of two years’ healthcare experience, home health or home medical equipment experience preferred; knowledge of adaptive equipment/durable medical equipment.
Experience working with individuals with chronic conditions or severe and persistent mental illness
Strong knowledge of Medicaid, behavioral health systems, and local community resources
Demonstrates strong critical thinking and problem solving skills and flexibility in relationship to job requirements.
Computer skills sufficient to enter and process consumer information, report preparation, and use CareStar’s website and email, and familiarity with suite of Microsoft Office programs.

Responsibilities

Reviews requests for home modifications to assess for completeness and to determine if criteria for approval are met.
Communicates with case managers as needed regarding the request.
Completes denials for requests not meeting criteria for coverage.
Initiates bid process for requests meeting criteria for coverage.
Presents competing bids to CareStar home modification/adaptive assistive device review committee.
Notifies providers of outcome of CareStar home modification adaptive assistive device review committee.
Completes paperwork to initiate payment to providers upon satisfactory completion of jobs.
Communicates with other team members as needed.
Identifies problematic cases and works with other Home Modification Specialists and Clinical Managers towards a resolution.
Maintains appropriate recordkeeping regarding home modification and adaptive/assistive devices, including making timely entries into the agency's electronic database.
Prepares Appeal Summaries and participates in consumer appeal hearings as a State agency representative.
Adhere to the CareStar Rule in performance of job responsibilities.
Understand and comply with CareStar Policies and Procedures.
Maintain confidentiality as related to patient information. Any disclosures of confidential information made unlawfully outside the proper course of duty will be treated as a serious disciplinary offense.
Follow the Acceptable Use Policy while using any information systems owned or controlled by CareStar, Inc.