Care Specialist III

5 days ago

Abilene, Texas, United States Texas Department of Aging & Disability Services Full time
Job Summary:

We are seeking a highly skilled Care Specialist III to join our team at the Texas Department of Aging & Disability Services. As a key member of our Program Support Unit, you will play a critical role in ensuring the delivery of high-quality Long Term Services and Supports (LTSS) to our clients.

Key Responsibilities:
  • Provide case management services to individuals enrolled in Medicaid waiver programs, including helping them select a managed care organization (MCO) and approving or denying eligibility for waiver services.
  • Work closely with case managers, service providers, and other stakeholders to ensure seamless transitions of care and effective service delivery.
  • Develop and explain Medicaid waiver programs to applicants and members, and coordinate with MEPD staff for enrollment in waiver programs.
  • Perform interest list activities, including confirming contact information and mailing enrollment packets.
  • Interpret policy and coordinate activities related to transitioning individuals from nursing facilities to the community, handling the transition of children aging out of MDCP services, and people who transition in and out of waiver programs.
  • Handle continuum of care issues related to LTSS for Medicaid waiver members who have been disenrolled or transferred in or out of managed care service areas.
  • Assist Medicaid Waiver members who have been denied services to file a fair hearing with the state and track and monitor appeal processes.
Requirements:
  • Knowledge of Medicaid waiver programs, policies, and procedures.
  • General knowledge of community and government service delivery systems, case guidelines, regulations, and policies.
  • Ability to communicate effectively orally and in writing with all types of people, in all types of situations.
  • Ability to operate computer equipment and be proficient in the use of Outlook, Excel, Word, and various state software programs.
  • Ability to manage stress in high-profile situations while maintaining a professional demeanor.
Working Conditions:

This position requires frequent contact with case managers, service providers, and other stakeholders, and may involve working in a fast-paced environment with multiple priorities and deadlines.

Education and Experience:

A bachelor's degree in a related field and at least 2 years of experience in a related field are required. A master's degree or higher may be preferred.

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