Company Overview
Almost Family is hiring a Waiver Case Manager for our Owensboro service area . This position requireds experience in the Health & Human Services field, primarily with aging and/or disabled clients; OR, an RN background with two years experience in the field of aging and/or disabilities. This is a PRN pay per visit opportunity, and we offer flexible schedules and weekly pay!
The Waiver Case Manager provides a wide range of services to patients in the home including overall coordination of the person-centered service plan and team.
Almost Family, a division of LHC Group, is the preferred post-acute care partner for hospitals, physicians and families nationwide. From home health and hospice care to long-term acute care and home and community-based services, we deliver high-quality, cost-effective care that empowers patients to manage their health at home. Hospitals and health systems around the country have partnered with LHC Group to deliver patient-centered care in the home. More hospitals, physicians and families choose LHC Group, because we are united by a single, shared purpose: It's all about helping people.
Essential Functions
• Responsible for performing case management functions for Kentucky Waiver programs.
• Complete timely initial visit to clients to explain waiver program.
• Communicate in a way that ensures the best interest of the client.
• Responsible for identifying the needs of the client and ensure needs are met.
• Educate the client and/or client representative regarding the case management process, personal rights, risks and responsibilities, and available resources.
• Lead the person-centered service planning team and take charge of coordinating and monitoring services through team meetings with all service providers and participants of the client’s person-centered service plan.
• Ensure participation of the client and/or client’s legal representative in the case management process.
• Assess the quality of services, safety of services, and cost effectiveness of services being provided to the client to ensure the success and efficiency of the person-centered care plan.
• Review and coordinate client’s eligibility in Kentucky Medicaid Waiver.
• Ensure reassessment is completed by the Department for Medicaid Services to maintain member eligibility prior to level of care end date.
• Ensure accurate updating of the client’s status in the Medicaid Waiver Management Application (MWMA) including (but, not limited to): termination from program, admitted to the hospital or skilled nursing facility, transferred to an alternate waiver program, or relocation of residence.
• Complete all appropriate Medicaid waiver forms and documentation and submit through the Medicaid Waiver Management Application (MWMA).
• Ensure client and/or client representative is provided information about participant direct services at the time of the initial person-centered care plan, at least annually thereafter, and upon inquiry from the client and/or client representative.
• Complete all case notes in the MWMA.
• Maintain Participant Directed Service (PDS) employee paperwork and chart, as applicable.
• Train PDS employees and clients, as applicable.
• Work with PDS Manager to assure client’s needs are being met.
• Assure Prior Authorization letters are received for billing.
• Direct waiver referrals, in a timely manner, to the Aging and Disability Resource Center (ADRC) staff.
• Advocate on behalf of the client and family with appropriate community resources.
• Monthly home visits/phone calls to monitor service delivery and progress toward member’s goals.
• Work closely with traditional provider agencies, local Department for Community Based Services, Department for Aging and Independent Living, and Department for Medicaid Services.
• Work with clients to solve eligibility issues.
• Monitor client budget to assure client is within guidelines.
• Issue a client corrective action plan if client does not comply with the person-centered service plan, as applicable.
• Provide conflict-free case management or ensure completion of exemption, as applicable.
• Follow all organizational policies and procedures.
• Supports and participates in the Quality and Performance Improvement program.
• Supports and complies with organization’s Corporate Compliance program.
• Attends and completes all in-service and education requirements of the organization.
• Completes all other duties as assigned.
• All other duties as assigned.
Education & Experience
License Requirements
• A bachelor’s or master’s degree in a health and human service field and at least (1) year experience in a health and human service field or the educational equivalent in the field of aging or disabilities or be a Kentucky licensed registered nurse with at least (2) years of experience in the field of aging or disability or a master’s degree in health or human services field.
SKill Requirements
• Broad knowledge base of special needs groups, community groups, and service organizations.
License Requirements
• A bachelor’s or master’s degree in a health and human service field and at least (1) year experience in a health and human service field or the educational equivalent in the field of aging or disabilities or be a Kentucky licensed registered nurse with at least (2) years of experience in the field of aging or disability or a master’s degree in health or human services field.
SKill Requirements
• Broad knowledge base of special needs groups, community groups, and service organizations.
$0 per YEAR Employment Type: UNAVAILABLE