Case Manager

Job Type
Full-time
Description
POSITION OVERVIEW:
TheCase Manager provides case management for assigned individuals receiving services through one of the Home and Community Based Waiver or State Funded programs managed by Mesa Developmental Services. Case Management includes assessment, service plan development, monitoring, referral and related activities. The Case Manager assures provision of quality services to assigned individuals consistent with the individual's stated goals and desires, MDS policies and prevailing statutes and regulations. TheCase Managercompletes documentation and billing for all assigned activities in a timely and professional manner.
JOB FUNCTIONS:
Job functions are considered essential (all individuals in this position must be able to complete these duties with or without reasonable accommodation) unless otherwise denoted in italic type . Duties noted in italic type may be reassigned by a supervisor.
SERVICE AND SUPPORT COORDINATION
Serves as an advocate and service coordinator for assigned individuals and assists individuals acquiring services and supports to meet their individual goals, needs and objectives through the chosen program approved services agencies. Coordinates resources and service delivery with other departments and program approved service agencies and monitors quality and timeliness of service delivery.
PROGRAM SERVICES
Establishes and convenes Interdisciplinary Teams (IDTs) for assigned individuals and develops Service Plans (SPs) reflecting individual needs and desired outcomes. Monitors provision of services and regularly evaluates individual progress and service effectiveness. Works with individuals, their family members and program staff and monitors individuals on a face-to-face basis at home and at program sites at the frequency required by regulation. Documents issues or conditions affecting individual progress, investigates and responds to individual service needs and coordinates conflict resolution and crisis intervention services. Reports and follows up on
Critical Incidents as required by regulation. Routinely schedules IDT meetings and modifies Service Plans to reflect programmatic changes as needed.
PLACEMENT SERVICES
Coordinates movement of individuals within the Colorado Developmental Disability (DD) system or exit from the system. Upon termination of services, locates appropriate receiving providers, coordinates with placement managers at the receiving CCB and assures appropriate information is provided and records are maintained. Prepares the individual and individual's family for transfer/termination.
MONITORING UTILIZATION OF SERVICES
Monitors utilization of services per state regulation to determine if indivdiuals are over or under utilizing the supports authorized. Revises indivdual's Service Plans to increase or decrease funding allocated as needed due to changes in support needs. Reviews and authorizes payment for services provided by approved provider agencies and third party providers and follows up with discrepancies, billing errors, etc. Enters requisite log note documentation on each individual for each activity completed. Ensures per person per month (PMPM) documentation and invoicing is complete.
ADVERSE ACTIONS AND APPEALS
Provides Notice of Action (803) notification to indivduals and/or authorized representative of either a denial or service reduction/change and their right to appeal should they disagree with the decision. Represent his/her actions at Administrative Law Judge hearings when the individual/authorized representative appeals a denial or adverse action affecting his/her program eligibility or receipt of services.
POLICIES/STANDARDS
Maintains knowledge of MDS policies, regulatory requirements and licensing standards and assures program compliance .
MANAGEMENT INFORMATION
Develops, maintains and utilizes manual and electronic individual case records (Therap) for use in monitoring program efficiency, quality assurance and compliance with MDS policies, departmental procedures and applicable laws and regulations. Completes required documentation in state data management systems (BUS, Bridge, DDD Web) correctly and in a timely manner.
BILLING AND DOCUMENTATION OF CASE MANAGEMENT SERVICES
Assures that case management services are billed correctly, in a timely fashion and in accordance with applicable laws, regulations and standards. Ensures that billing efficiency meets the stated standard. Assures notes and documentation prepared to support billing is maintained and destroyed in accordance with MDS policy and all applicable laws and regulations.
ASSISTIVE TECHNOLOGY
Assures individuals are assisted in obtaining devices and adaptations to overcome barriers impeding their progress and development.
OTHER DUTIES Performs other duties as assigned.
ADDENDUM
A list of assignment specific duties is is not included as an addendum to this job description.
The addendum may also identify assignment specific job requirements/specifications.
Requirements
JOB REQUIREMENTS/SPECIFICATIONS:
Required Education/Experience/Skills/Knowledge/Licenses:
• Bachelor's degree from an accredited college or university with a preferred major in Human Services, Social Sciences, Counseling, Sociology or Psychology
• Valid driver's license and a driving record that meets MDS standards
• Personal vehicle available for work-related travel
• Proficiency in various computer software systems
Preferred Requirements
Minimum of one-year case management experience preferred
Work Environment
Job functions are generally performed in an office environment. Driving is required on a regular or frequent basis.
Physical Requirements
Ability to access individual residences, vocational sites, community resources and service providers. Ability to operate office equipment including, but not limited to, telephone, computer, fax and copy machine.
Salary Description
$18.00