Home Based 1: Medicaid Waiver Case Manager (RN or LSW required)

SUMMARY: Live in Chillicothe area and work from home doing client home visits in Ross County and surrounding area. Provide case management services for individuals enrolled in Nursing Facility Level of Care Medicaid waivers by conducting ongoing assessment of enrolled individual’s service and support needs. Collaborate with individuals and paid providers, informal supports, medical providers, and community resources to coordinate a comprehensive care plan. Implement services to meet identified needs within designated cost targets. Evaluate appropriateness of services and monitor outcomes to ensure individual’s needs are being met. Will be assigned to case management programs contracted with AAA7 as dictated by program caseloads and needs.

• *ESSENTIAL FUNCTIONS:**

• Conduct annual and event-based assessments within assigned waiver program guidelines.

• Maintain a person-centered service plan (PCSP) for assigned individuals that identifies and integrates consumer strengths and weaknesses, individualized goals, proposed interventions, and desired outcomes. Maintain contact with formal/informal supports involved in the PCSP and provide copies/obtain signatures acknowledging the plan according to program guidelines.
• Conduct routine and as needed contacts/phone calls and in person visits for the purpose of monitoring care needs and service delivery according to schedule specified by assigned waiver program.
• Educate individuals, caregivers/informal supports, and community agencies regarding long term service and support options and assist consumers to access waiver services as well as community resources.
• Document information and activities and upload signed documents in the program specific electronic medical record according to requirements and timeframes specified by assigned waiver program.
• Collaborate with Medicaid support staff to assist individuals to maintain Medicaid eligibility as appropriate including educating individuals about any share of cost/financial liability incurred with program enrollment.
• Respond to phone calls/emails/communication regarding assigned individual’s needs within one business day as appropriate.
• Complete incident reports within time frames specified in rule and investigate/mitigate contributing factors according to assigned program guidelines.
• Reports issues/concerns with formal providers to appropriate Provider Management entity.
• Monitor for ongoing waiver program eligibility of assigned individuals and completes disenrollment process when determined ineligible including providing discharge planning/transition of care services as appropriate.
• Provide notices of adverse actions and hearing rights according to Medicaid and assigned waiver program rules.

Job Type: Full-time Pay: $60,000.00 per year

Benefits

• 403(b)
• Dental insurance
• Disability insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Retirement plan
• Vision insurance

Application Question(s)

• Do you live in Ross County--preferably the Chillicothe area?

License/Certification

• RN or LSW License (Required)

Work Location: Hybrid remote in Jackson, OH 45640 Apply tot his job Apply To this Job