Medicaid Waiver Case Manager
About The Position
The Medicaid Waiver Case Manager implements the Medicaid Waiver Home and Community-based Services Program within the SARPC area in accordance with Medicaid Waiver guidelines. The position receives general instructions from the Medicaid Waiver Team Lead, who establishes limitations, expected quality and quantity, deadlines, and priorities. The case manager uses initiative to carry out assignments, and work is checked for technical accuracy. The role involves establishing referral sources; assessing potential clients and submitting enrollment documentation; coordinating and monitoring services and care plans; visiting clients and contractors; reviewing contractor billings; conducting annual redeterminations; and maintaining program records and reports. The position requires regular driving and may involve physical exertion, including standing, walking on uneven surfaces, bending, reaching, and lifting record boxes. The position has no supervisory responsibilities.
Requirements
- Knowledge of social work programs and processes.
- Knowledge of community resources and support networks available to the clientele served.
- Excellent oral and written communication skills.
- Ability to relate to elderly people and their unique problems.
- Ability to write and print legibly.
- Ability to operate office equipment, including a telephone, copy machine, fax machine, computer, and calculator.
- Basic arithmetic ability.
- Ability to read and interpret guidelines and regulations and apply them to the job.
- Complete initial case manager training within three months of employment.
- Bachelor’s degree from an accredited four-year college or university in Social Work, Behavioral Sciences, Psychology, Geriatric Studies, or a related field.
- At least three months of work experience in a social work or related program.
- Valid driver’s license and good driving record.
Responsibilities
- Establish referral sources by sharing program information with organizations, agencies, and individuals; receive and respond to verbal and written referrals concerning eligible Medicaid recipients.
- Conduct and prepare on-site assessments of potential clients, submit completed forms to the appropriate state agency, and follow up on their status to fill available program slots in a timely manner.
- Authorize contractors to initiate services after approval from the Alabama Medicaid Agency and forward assessments, care plans, and service authorization forms to the contractors.
- Visit contractors’ offices and exchange information with appropriate personnel to ensure contractors operate according to guidelines.
- Develop, monitor, and revise client care plans in coordination with clients or caregivers.
- Conduct monthly home visits and evaluate Medicaid Waiver services for appropriateness, adequacy, and quality; document visits and evaluations in case files.
- Review monthly contractor billings for accuracy and conformity with client care plans, and monitor the cost effectiveness of Waiver services for each client.
- Conduct yearly redetermination assessments and complete HCBS forms according to Medicaid Waiver guidelines and Alabama Medicaid Agency requirements.
- Compose and maintain the HCBS Program Case Management Activity Record and Case Managers Daily Time Logs as necessary.
- Communicate with Medicaid Waiver clerical staff in writing and verbally to assign work and follow up on tasks.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
