Waiver Service Coordinator - MyCare Ohio, Anthem

WESTERN RESERVE AREA AGENCY ON AGING • Cleveland, OH

1d • Hybrid

About The Position

The MyCare Ohio, Anthem - Waiver Service Coordinator is responsible for the coordination of all services and the authorization of all waiver services for assigned members enrolled in community-based waiver programs. Social Worker (LSW) or Registered Nurse (RN) licenses are required. At least one year of experience working with individuals with physical and/or behavioral disabilities in a home health care, medical social work, or behavioral health environment is required.

Requirements

• Current licensure as a Social Worker by the State of Ohio Counselor and Social Work Board, or as a Registered Nurse with the Ohio Board of Nursing.
• At least one year of experience working with individuals with physical and/or behavioral disabilities in a home health care, medical social work, or behavioral health environment is required.
• Excellent verbal and written interviewing and assessment skills.
• Basic knowledge of major chronic disabling illnesses for people of all ages, disease processes, and normal aging or special knowledge in pediatrics and young adults.
• Ability to effectively communicate with the disabled and elderly populations and general public, both in person and by phone.
• Ability to communicate in a collaborative, effective manner with others and to maintain good working relationships.
• Ability to comprehend written material related to essential job functions.
• Ability to comprehend basic medical terminology.
• Knowledge of local resources for older adults and people with disabilities.
• Ability to comprehend, recall, and apply facts related to essential job functions.
• Ability to analyze, evaluate, and implement a reasonable course of action based on available information.
• Ability to detect specific odors related to the assessment of a client’s health/hygiene and the safety of the client’s environment.
• Ability to ambulate enough to access private homes/locations which may not be readily accessible.
• Must have basic computer skills, including Microsoft Office applications.
• Ability to use and transport a laptop computer and case, therefore, must be able to lift/carry a minimum of twenty (20) pounds.
• Must have a car available during working hours, as well as the ability to legally drive a car.

Nice To Haves

• Self-motivated and compassionate Social Workers (LSWs) and Registered Nurses (RNs) looking to be part of a Best-in Class organization
• Team players who are committed to providing superior service to all they serve
• Enthusiastic professionals excited to grow with an organization that values dedication, innovation and collaboration.

Responsibilities

• Evaluate assessment and care management data to determine ongoing care needs and service options.
• Complete initial MyCare Ohio assessment, annual and event-based assessment process (if applicable to MCO plan).
• Complete enrollment process of eligible consumers into the appropriate program (if applicable).
• Develop and implement a waiver services care plan for members and collaborate with Assisted Living Facility staff to develop and implement a waiver services care plan for all AL enrollees as appropriate.
• Waiver Service Plans include interventions to address a consumer’s unstable conditions
• Collaborate with the Departments of Job and Family Service to establish and/or maintain Medicaid eligibility.
• Monitor and evaluate the waiver services care plan, service quality and program eligibility.
• Provide education and support to consumers and their caregivers.
• Advocate on behalf of members and/or caregiver/family and assist individuals in securing appropriate services and care settings in collaboration with MCO Care Managers and providers of service(s)
• Transition dual eligible consumers into MyCare Ohio as appropriate
• Collaboration with the managed care plan Care Manager for approval especially in regard to Minor Home Modifications and Durable Medical Equipment.
• Manage the acquisition of provider bids, MD prescriptions and Physical Therapy evaluations as needed.
• Authorize repairs and/or equipment as appropriate.
• Disenroll all ineligible consumers from the waiver program as appropriate.
• Apply judgments and perform clinical practice based upon education, experience and professional practice standards.
• Maintain minimum proficiency in all requisite computer applications and software.
• Maintain consumer confidentiality according to agency policy.
• Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by Ohio law.
• Abide by the professional code of ethics established by licensure.
• Participate in trainings, meetings, in-services and continuing education opportunities; also participate in MyCare Ohio trainings and meetings as requested by supervisor, manager or assigned Managed Care Plan.
• Meet time frames for timely and accurate completion of documentation.
• Ability and willingness to travel to community and consumer locations within our five county service areas (Cuyahoga, Lorain, Geauga, Lake and Medina counties).
• Perform other duties as assigned by supervisor as needed to meet agency goals.
• This position's primary duty is to perform work directly related to the successful operation of the Agency. Accordingly, the employee must exercise discretion and independent judgment with respect to matters of significance.
• All staff have the responsibility and authority to propose ways to improve quality and to fully participate in quality improvement efforts.

Benefits

• A generous six-week PTO program
• thirteen paid holidays
• A $750.00 investment in professional development through a substantial, annual training funds allotment
• A 401K program with company match
• Paid parking in a covered parking garage
• Medical, Dental, Vision Benefits

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 101-250 employees