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Long Term Services Coordinator
2 months ago
The Texas Department of Aging & Disability Services is seeking a dedicated professional to join our Program Support Unit (PSU) as a Community Care Worker III. This role involves executing moderately complex responsibilities associated with managed care Long Term Services and Supports (LTSS).
In this position, you will engage regularly with case managers in Community Care Services Eligibility (CCSE), individuals seeking or enrolled in waiver services, service providers, LTSS Managed Care Organizations (MCOs), relocation specialists, nursing facility personnel, and various stakeholders within the Health and Human Services Commission.
Working under general supervision, you will have the autonomy to utilize your initiative and independent judgment while performing your duties. Proficiency in computer operations and a comprehensive understanding of CCSE/PSU programs and software are essential.
Key Responsibilities:
Attend work consistently and adhere to agency leave policies while fulfilling additional assigned tasks.
Develop, coordinate, and clarify Medicaid waiver programs for applicants and members. Make decisions to authorize or deny waiver services, ensuring timely communication of approval or denial notices to relevant parties. Validate eligibility within designated systems and register waiver program eligibility accordingly. Collaborate with MEPD staff for Medicaid Waiver program enrollment. (50%)
Conduct interest list activities, which include verifying accurate contact information, distributing enrollment packets, determining preferred MCOs for individuals, and performing necessary follow-ups to facilitate assessments for Medicaid Waiver programs.
(10%)Interpret policies and manage activities related to the transition of individuals from nursing facilities to community settings, including the transition of children aging out of Medically Dependent Children Program (MDCP) services.
(10%)As needed, reach out to appropriate contacts to address obstacles and document any delays encountered.
(5%)Address continuum of care issues for Medicaid waiver members who have experienced disenrollment or transfers between managed care service areas, ensuring they receive uninterrupted services.
(10%)Assist Medicaid Waiver members with denied services in filing fair hearing requests with the state and monitor the appeal process until a decision is reached. (5%)
Perform tasks such as generating reports to oversee program operations, investigating and resolving enrollment discrepancies, and referring members who lose Supplemental Security Income (SSI) eligibility to MEPD.
(10%)Required Knowledge, Skills, and Abilities:
Comprehensive understanding of Medicaid waiver programs, policies, and procedures.
General knowledge of community and governmental service delivery systems, case guidelines, regulations, interviewing techniques, mental health considerations, and resources available for individuals with disabilities.
Proficient communication skills, both oral and written, enabling effective interaction with diverse individuals in various situations.Ability to convey instructions clearly, negotiate available services, and provide training to others.
Proficiency in operating computer systems and familiarity with software such as Outlook, Excel, and Word, along with a general understanding of state software programs.
Ability to manage stress in high-pressure situations while maintaining professionalism, identify systemic issues, and develop solutions. Competence in multitasking and effectively managing workload to achieve Medicaid waiver program objectives within established timeframes.
Proactive in identifying potential service delivery issues and implementing preventative measures. Strong organizational skills to prioritize tasks based on importance and deadlines.
