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Case Manager Per Visit

2 months ago


Louisville, United States LHC Group Full time

Summary We are hiring Waiver Case Managers for Visits in the surrounding areas of Louisville, KY. Experience working with Aging and/or Disabled Clients At Least 6 months experience with Medicaid Waiver Process Flexible Scheduling Earn PTO while working 32+ Hours per Week At Almost Family Home and Community Based Services, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy themeaningful 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 aWaiver 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 greatopportunity for you. Responsibilities 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. 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. 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. Equal Opportunity Employer - vets, disability.