Act Waiver Case Manager

SUMMARY DESCRIPTION:

The ACT Waiver Case Manager is responsible for assisting individuals in the nursing home setting with the transition to community living. The position also includes gaining access to necessary waiver and other services, as well as needed medical, social, educational and other appropriate services. The ACT Case Manager determines a client’s eligibility, need for services, and monitors the provision of services while also assisting with housing or other needs.

SUPERVISORY CONTROLS:

Receives general supervision from the Assistant Medicaid Wavier Coordinator. Supervisor sets the overall objectives and employee and supervisor, in consultation, develop the deadlines, projects, and work to be done; employee is responsible for planning and carrying out the assignment; and work is reviewed only from an overall standpoint.

RESPONSIBILITIES AND DUTIES:

Case Management:
1. Maintain weekly contact with ADSS staff & Transition Coordinator throughout the transition process.
2. Conduct nursing home visits to assess client’s eligibility for ACT.
3. Complete home assessments prior to nursing home discharge to assess any needed modifications (examples: widen doorways, build ramps, threshold ramps, etc.
4. Complete and process level of care applications for admission, readmission or redetermination of eligibility.
5. Coordinate external services necessary for community living (examples: DME providers & supplies, home health referrals, food stamps, government telephone applications, etc.)
6. Ensure appropriate home set-up prior to transition including shopping, delivering, & assembling transitional items such as furniture.
7. Make, at a minimum, a monthly face-to-face visit with each client to monitor the Plan of Care.
8. Monitor the quality and effectiveness of waiver and non-waiver services provided to the client.
9. Process termination of waiver eligibility and services.
10. Establish and maintain accurate case file records.

Education and Outreach:
1. Perform program outreach functions in the community. Explain to clients and others the case management program goals and eligibility requirements.

Record Keeping and Reporting:
1. Maintain and review records, correct and report discrepancies in records for quality improvement purposes.
2. Develop, prepare, and analyze management reports about productivity and accuracy related to review activities
3. Record activities and time spent.
4. Prepare reports of work activity, and other reports as needed.

Miscellaneous:
1. Develop and maintain general knowledge of the Medicaid Waiver program and of any other programs for which job duties are performed.
2. Participate in various education and or training activities as required.
3. Participates in health fairs.
4. Other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
1. Knowledge of social work programs and processes, preferred.
2. Knowledge of community resources and support network available to clientele served.
3. Excellent communication skills, both orally and written.
4. Excellent organizational and time management skills.
5. Ability to relate to the elderly and their unique problems.
6. Knowledge and ability to operate office equipment including telephone, copy machine, fax machine, computer, and calculator.
7. Knowledge and ability to do basic arithmetic. Experience with budgeting preferred.
8. Ability to read and interpret guidelines and regulations and apply them to the job.
9. Bachelor’s Degree from an accredited four-year college or university in Social Work, Behavioral Sciences, Psychology, Geriatric Studies, or a related field with a minimum of one (1) years of related work experience; hold an active, unrestricted Registered Nurse (RN) license in the state of Alabama.
10. A valid driver’s license and a good driving record.

WORK CONDITIONS:
The work requires some physical exertion such as long periods of standing; walking over rough, uneven, or rocky surfaces; recurring bending, crouching, stooping, stretching, reaching, or similar activities; recurring lifting of moderately heavy items such as record boxes. This position requires driving on a regular basis.

SUPERVISORY RESPONSIBILITIES:

None