Community Care Specialist III

2 weeks ago


Abilene, Texas, United States Health & Human Services Comm Full time
Job Summary:
We are seeking a highly skilled Community Care Worker III to join our team at the Health and Human Services Commission. As a Community Care Worker III, you will play a critical role in supporting individuals with long-term services and supports (LTSS) needs.

Key Responsibilities:
• Develop, coordinate, and explain Medicaid 1115 waiver programs to applicants and members.
• Authorize or deny waiver services, by sending approval or denial notices to applicants, members, and other key parties.
• Validate eligibility in appropriate systems.
• Register waiver program eligibility in appropriate systems, authorize MCOs to begin approved services.
• Coordinate with MEPD staff for enrollment in a Medicaid 1115 Waiver program.
• Perform interest list activities such as confirming contact information is accurate, mailing enrollment packets, determining which MCO individuals want to enroll with, making follow-up contacts as needed, and ensuring individuals' wish to be assessed for a Medicaid 1115 Waiver program.
• Interpret policy and coordinate activities related to transitioning individuals from the nursing home to the community, handling the transition of children aging out of MDCP services, and people who transition in and out of a Medicaid 1115 Waiver program.
• As appropriate, contact the appropriate person to assist with resolution of obstacles and document the reason for the delay.
• Handle continuum of care issues related to LTSS for Medicaid 1115 waiver members who have been disenrolled or transferred in or out of managed care service areas and are experiencing a gap in services.
• Assist Medicaid 1115 Waiver members who have been denied services to file a fair hearing with the state. Track and monitor appeal processes through to the decision.
• Handle duties such as complete reports to monitor program operations, research and resolve errors in enrollment, and make referrals to MEPD for members who lose Supplemental Security Income (SSI) eligibility.

Requirements:
• High School Diploma or GED required.
• Preferred experience with STAR+PLUS Home and Community Based Services program, Medically Dependent Children Program (MDCP), Long Term Services and Supports (LTSS), and/or experience with Medicaid for the Elderly and People with Disabilities (MEPD) services.
• Preferred experience with various types of computer equipment and software including, Outlook, Word, and Excel.
• Preferred experience with state software such as TIERS and SAS.

What We Offer:
• Telework opportunities are available in accordance with business needs.
• A dynamic and supportive work environment.
• Opportunities for professional growth and development.
• A competitive salary and benefits package.

How to Apply:
If you are a motivated and detail-oriented individual who is passionate about supporting individuals with LTSS needs, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to the Health and Human Services Commission.

Equal Employment Opportunity:
The Health and Human Services Commission is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive work environment that values diversity and promotes equal opportunities for all employees.

Accommodation:
If you need assistance completing the online application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

Language:
English
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