Veteran-Directed Care Manager

WESTERN RESERVE AREA AGENCY ON AGING•North Olmsted, OH

3d•$26 - $0•Hybrid

About The Position

The Veteran-Directed Care (VDC) Veteran Directed Care Manager (VDCM) is responsible for providing person-centered counseling, care coordination, and ongoing support to Veterans enrolled in the Veteran-Directed Care program. The PCC partners with Veterans, Authorized Representatives (ARs), caregivers, Veterans Affairs Medical Center (VAMC) staff, Fiscal Management Services (FMS), and community providers to develop and monitor individualized spending plans that support the Veteran’s goals, independence, and ability to remain safely in the community. The PCC serves as the primary point of contact for Veterans throughout their participation in the VDC program and ensures compliance with Veterans Affairs (VA) requirements, program standards, and organizational policies.

Requirements

Bachelor’s degree in Social Work, Human Services, Psychology, Gerontology, Nursing, Rehabilitation Counseling, or a related field required.
Minimum of two years of experience in case management, care coordination, social services, aging services, disability services, veterans services, healthcare, or a related field preferred.
Experience working with older adults, individuals with disabilities, or Veterans strongly preferred.
Licensed Social Worker (LSW), Licensed Independent Social Worker (LISW), Registered Nurse (RN), or other relevant professional credential preferred but not required.
Valid driver's license, reliable transportation, and proof of insurance required.
Knowledge of person-centered planning principles and self-directed service models.
Knowledge of aging, disability, long-term services and supports, and community-based services.
Ability to conduct assessments and develop individualized service plans.
Strong case management, organizational, and problem-solving skills.
Ability to interpret and apply program policies, procedures, and regulations.
Excellent verbal and written communication skills.
Ability to build rapport with Veterans, caregivers, and interdisciplinary partners.
Proficiency with electronic documentation systems, Microsoft Office applications, and virtual communication platforms.
Ability to work independently while managing multiple priorities and deadlines.

Nice To Haves

Experience working with older adults, individuals with disabilities, or Veterans strongly preferred.
Licensed Social Worker (LSW), Licensed Independent Social Worker (LISW), Registered Nurse (RN), or other relevant professional credential preferred but not required.

Responsibilities

Complete comprehensive person-centered assessments to identify Veteran strengths, needs, preferences, goals, and support requirements.
Conduct initial and ongoing assessments in accordance with VDC program requirements and established timelines.
Assist Veterans in developing individualized spending plans that reflect their assessed needs and personal goals.
Facilitate Veteran choice and self-direction by supporting informed decision-making regarding services, supports, workers, and purchases.
Develop and maintain emergency back-up plans with Veterans and caregivers.
Calculate annual budgets using the approved Case Mix Rate and budget tools.
Develop, review, and update spending plans in collaboration with Veterans, Authorized Representatives, caregivers, and VAMC staff.
Ensure spending plans remain within authorized budget limits and meet program requirements.
Review proposed purchases for compliance with VA guidelines and funding source limitations.
Monitor spending plan utilization and assist Veterans in making adjustments throughout the authorization period.
Submit spending plans, revisions, and supporting documentation to the VAMC for review and approval.
Maintain regular contact with Veterans through home visits, telephone calls, virtual meetings, and other approved methods.
Coordinate services and supports among Veterans, caregivers, direct care workers, community providers, Fiscal Management Services, and VAMC staff.
Assist Veterans with recruitment, selection, training, and management of direct care workers.
Identify service gaps, barriers to care, and unmet needs and develop strategies to address them.
Respond to changes in Veteran needs and coordinate appropriate interventions.
Maintain accurate, complete, and timely documentation within electronic health record and case management systems.
Document assessments, contacts, spending plans, reassessments, progress notes, and significant events according to program requirements.
Upload required documents and communicate with VAMC staff through approved platforms.
Ensure compliance with VA regulations, Veteran-Directed Care requirements, agency policies, confidentiality standards, and documentation expectations.
Participate in quality assurance activities, audits, and program monitoring processes.
Advocate for Veteran choice, independence, dignity, and community inclusion.
Educate Veterans and caregivers regarding VDC program requirements, budget management, employer responsibilities, and available community resources.
Support Veterans in understanding their rights and responsibilities within the VDC program.
Promote self-direction and person-centered practices in all interactions.
Establish and maintain effective working relationships with Veterans, caregivers, VAMC personnel, Fiscal Management Services representatives, and community partners.
Participate in interdisciplinary team meetings, case conferences, and program trainings.
Remain current on VDC program requirements, VA directives, community resources, and best practices in person-centered planning.