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Waiver Case Manager - Home Care

LHC Group.

Location: 42303
Type: Non-Remote
Posted on: October 26, 2023
We are hiring Waiver Case Managers. We offer one-on-one patient care, weekly pay, and flexible schedules. RNs encouraged to apply! Experience working with aging and/or disabled clients and 1-year minimum knowledge of Medicaid Waiver process highly preferred!
At Almost Family Home and Community Based Services, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve—it truly is all about helping people. You can find a home for your career here.  ​
​As a Waiver Case Manager, you can expect:​
• flexibility for true work-life balance
• opportunities for career growth
• the ability to build trusted patient relationships
• employee-focused wellness and support programs
​If you love caring for people and want to strengthen your experience, this is a great opportunity for you.
Job Summary
Coordinates the integration of Case Management / Social Services functions for client’s participating in a waiver program in Kentucky. The Case Manager is responsible to lead a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates available services on an ongoing basis to meet the client’s health care needs. Acts as a patient advocate, performs staff education related to resource utilization, and discharge planning.
• 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.
Education and 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.
LHC Group is committed to a culture of diversity, equity and inclusion and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any legally other protected characteristic.
Almost Family Home and Community Based Services is part of the LHC Group family of providers – the preferred post-acute care partner for hospitals, physicians, and families nationwide. We deliver high-quality, cost-effective care that supports our patients when and where they need it. From our home health, hospice, and community-based services to inpatient care at our clinics and hospitals, our mission is to reach more patients and families with effective and efficient healthcare. More hospitals, physicians, and families choose LHC Group because we are united by a single shared purpose: “It's all about helping people.”