Medicaid Waiver Case Manager

South Alabama Regional Planning CommissionMobile, AL
$44,342 - $57,011Hybrid

About The Position

The Medicaid Waiver Case Manager is responsible for the implementation of the Medicaid Waiver Home and Community-based Services Program within the SARPC area, adhering to specific requirements outlined in Medicaid Waiver guidelines. The role involves establishing referral sources, conducting client assessments, developing and monitoring care plans, managing contractor services and billings, and maintaining program documentation.

Requirements

  • Knowledge of social work programs and processes.
  • Knowledge of community resources and support networks.
  • Excellent communication skills, both oral and written.
  • Ability to relate to the elderly and their unique problems.
  • Knowledge and ability to write and print legibly.
  • Knowledge and ability to operate office equipment including telephone, copy machine, fax machine, computer, and calculator.
  • Knowledge and ability to do basic arithmetic.
  • Ability to read and interpret guidelines and regulations and apply them to the job.
  • Completion of initial case manager’s training within three (3) 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 (3) months of work experience in a social work or related program.
  • A valid driver’s license and a good driving record.

Responsibilities

  • Establish referral sources by disseminating information to organizations, agencies, and individuals.
  • Receive and respond to verbal and written referrals of eligible Medicaid recipients to obtain information on potential clients and provide information to referral sources.
  • Conduct and prepare on-site assessments on potential clients for enrollment in the Medicaid Waiver Program.
  • Submit completed forms to the appropriate state agency and follow up on their status to meet enrollment targets.
  • Authorize contractors to initiate services after approval from the Alabama Medicaid Agency and forward necessary documentation.
  • Visit contractor offices to exchange information and ensure compliance with guidelines.
  • Develop, monitor, and revise client care plans in coordination with clients/caregivers.
  • Conduct monthly visits to clients' homes to evaluate services and ensure appropriateness, adequacy, and quality.
  • Prepare case notes of visits and evaluations for documentation.
  • Check monthly billings submitted by contractors for accuracy and conformity with Care Plans.
  • Monitor the cost-effectiveness of Waiver services for each client.
  • Conduct yearly redetermination assessments and complete HCBS forms as required.
  • Compose and maintain reports such as HCBS Program Case Management Activity Record and Case Managers Daily Time Logs.
  • Exchange information with Medicaid Waiver clerical staff for work assignment and follow-up.
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