Job Description

The Case Management Supervisor, under the direction of the Director of Aging & Independent Living and the Executive Director, is responsible for coordinating and organizing the Medicaid Waiver Program, the Kentucky Homecare, and the Title III-B In-Home Services (HC/III-B) Programs and ensuring program compliance with state and federal regulations. The Case Management Supervisor will prescreen new Waiver Program referrals, develop policies and regulations for HC/III-B Programs and all Waiver Programs, coordinate with other agencies on Waiver Program issues, work with partner agencies on new initiatives, provide leadership and train new and existing staff on regulations, policies, and responsibilities, and monitor program effectiveness. The Case Management Supervisor must maintain confidentiality of all clients.

General Duties and Responsibilities:

Home and Community Based (HCB) Waiver Coordination:

Involves prescreening new Waiver Program referrals, developing policies and regulations, coordinating with other agencies on Waiver program issues, training new and existing staff on policies, regulations, and responsibilities, and monitoring program effectiveness. This duty will consist of:Provide assessment and case management services for persons enrolled in Medicaid Waiver Programs in the Gateway Region, which include, but are not limited to Participant Directed Services, Traditional, and other pilot projects for Medicaid; Review files, documentation, and general work of Case Manager staff on a regular basis; Ensure staff are following the latest policies and procedures of the program and agency, which may include performing home and site visits with Waiver Case Managers; Conduct quality assurance checks on staff service plans, monthly case notes, employee packets, recertification packets, and exception packets; Track and review Lack of Information requests from Quality Improvement Organizations (QIO) until completed and submitted in a timely manner; Facilitate the Medicaid Waiver Management Application and enrollment of new referrals, and manage and assign District employee caseloads; Monitor participants' patient liability and Corrective Action Plans; Complete and submit all monthly required reports, such as Enrollment Reports, Quarterly Department for Aging and Independent Living Reports, and ad hoc reports as required by the Director of Aging & Independent Living and/or Executive Director; Ensure all deadlines are met for reporting and other Waiver-related work for the program; Review participant time entries and assist Waiver Case Managers in communicating errors with clients; Create Corrective Action Plans and respond to the Department for Aging and Independent Living and the Department for Medicaid Services when warranted; Back-up and vacancy coverage for Waiver Case Managers, such as completing home visits and phone contacts both as needed and required, ongoing service eligibility, as well as ongoing care plan for identified/continued needs; and Perform Waiver Case Manager duties and responsibilities and assume a limited caseload as determined by the Director of Aging & Independent Living and/or Executive Director.

Participant Directed Services (PDS) and Traditional Waiver Case Management:

Involves developing and maintaining a Plan of Care for PDS and Traditional Waiver clients, completing required home visits and telephone calls, and data entry. This duty will consist of:Conduct face-to-face visits every month with PDS clients and every other month with Traditional Waiver clients; Contact Traditional Waiver clients during the months that face-to-face visits are not performed; Conduct telehealth visits every other month with those PDS clients who have provided telehealth consent; Data entry and case notes in the Medicaid Waiver Management Application; Develop, maintain, modify, and review a Plan of Care for each client; Ensure services are being provided in accordance with the client's person-centered service plan; Work with Medicaid providers to ensure services are being provided in accordance with the Plan of Care; File maintenance and documentation; Assist the client in collecting new PDS employee paperwork, including withholding documentation, eligibility verification, and employees/client contract; Track PDS employee background checks, trainings, certifications, and other program requirements (i.e., Tuberculin (TB) skin tests, CPR/First Aid certification, attendant care training); Issue a corrective action plan when the Plan of Care is not being followed or when there is a threat to the health, safety, and welfare of the client; Terminate clients from the program when the program cannot sufficiently meet the client's requirements, when imminent threats exist to the client, when a client or representative refuses to follow the corrective action plan, or when services are not utilized within required timeframes; Review PDS employee time entries for completeness, compliance with the Plan of Care and Electronic Visit Verification (EVV) requirements; Evaluate the client's expenditures and balance of services available at each monthly face-to-face visit; and Conduct eligibility checks at the beginning of each month to verify that each client is Medicaid eligible and remains active.

Waiver Program Support and Development:

Involves providing program support to Waiver Case Managers and developing applicable policies, procedures, and trainings related to the program. This duty will consist of:Provide support and assistance to all Waiver Case Managers; Respond to staff with program and procedural questions; Assist with review and submissions of Incident reports for the team; Assist staff with the facilitation of case conferences and in managing complex situations; Coordinate, in conjunction with the Director of Aging & Independent Living, all training and professional development of Waiver Case Managers, both new and continuing education; and Schedule and conduct monthly team meetings.

Electronic Visit Verification (EVV):

Involves collaborating with Gateway Area Development District's Finance Department to correct issues with EVV and payroll for the Medicaid Waiver Program. This duty will consist of: Address participant's comments/complaints/questions in a professional manner; Review PDS employee EVV system usage to ensure accuracy; Identify and make EVV corrections following correction submissions or visit notes; Troubleshoot EVV issues with checking in/checking out; Follow up with employee(s) on inconsistencies with EVV's geofencing and submitted visits; and Help maintain clients and users in the EVV system to prevent inactive users.

Homecare & Title III-B In-Home Coordination:

Involves managing and coordinating the Homecare & Title III-B In-Home programs, ensuring regulations for the program are followed, and meeting program goals and objectives. This duty will consist of:Provide direction to the program case manager; Assume case management duties during position vacancies; Conduct monthly program reporting; Monitor participant files and document findings for corrections; Monitor units of service, outcome measures, and the program/participant budgets; Maintain a waitlist for program services when applicable; Conduct quarterly phone contact with waitlist individuals; Address and resolve participant comments/complaints in a timely and professional manner; Complete Corrective Action Plans as necessary; Track reassessment completions; Track and compare services ordered verses services delivered; and Review all closed participant cases.

Public Relations:

Involves facilitating and engaging in various levels of communications, maintaining contact with administrative agencies, and participating in required state meetings and trainings. This duty will consist of:Communicate with external providers, clients, and agencies to ensure service delivery and coordination of services; Participate in community education sessions to promote the program(s) as well as state-level meetings and trainings; Participate in monthly Department for Aging and Independent Living meetings; Coordinate communications with the Department for Aging and Independent Living and the Department for Medicaid Services regarding issues around program operations and/or consumer issues; and Serve as the liaison, along with the Director of Aging & Independent Living, between consumers, Waiver Case Managers, the Department for Aging and Independent Living, and the Department for Medicaid Services.

Other Duties:

Involves any other tasks and assistance needed to support the Aging & Independent Living Department.

Qualifications:

Education:

Bachelor's degree or higher in a social work, gerontology, psychology, sociology, or a field related to geriatrics from an accredited college or university; or a bachelor's degree in any field not related to geriatrics with two (2) years of experience working with elderly; or have a master's degree in a human services field from an accredited college or university; or an associate degree in a health or family services field and two (2) years of experience working with the elderly; or be a registered nurse currently licensed in Kentucky who has at least two (2) years of experience working with the elderly; or be a licensed practical nurse currently licensed in Kentucky who has three (3) years of experience working with the elderly.

Certification and Trainings:

Valid Driver's License required. Negative Tuberculin (TB) skin test required. Obtain CPR/First Aid certification within six months of hire date and maintaining certification thereafter. Employees will be expected to attend professional development trainings related to programs and services provided within the Aging & Independent Living Department. Registered Nurses must maintain a valid license as a condition of continued employment.

Experience:

Intermediate Level Position. Meet educational requirements and have four (4) or more years of case management experience.

Physical Requirements:

Sit for extended periods of time; stand and walk for extended periods of time; reach, stoop, crouch, bend; ability to lift and carry approximately 30 pounds; fine motor skills; and operate a vehicle.

Sensory Requirements:

Sight; Hearing; Speaking

Working Conditions:

Indoor office conditions; outdoor conditions during various weather conditions and on various terrains; possible wildlife/animal encounters during home visits; requires intermittent standing, sitting, or stooping; work requires consistent use of computer and phone systems as well as other general office equipment; and frequent interruptions.

Availability and Travel:

Normal business hours; nights/weekends (special events/training/local meetings); regular travel within region and state; occasional travel outside of the state; able to travel multiple days at a time; and must be able to attend meetings and answer calls during evenings and weekends.

Tools, Equipment, and Vehicle Use:

Standard office equipment (computers, printers, scanners, phones, etc.); and fleet/personal vehicle(s).

Knowledge, Skills, and Abilities:

Knowledge:

Federal and state programs and guidelines for the elderly and disabled; Social and economic conditions of the region; Record keeping and reporting requirements; Policies and procedures as regulated by the Department for Aging and Independent Living and the Department for Medicaid Services; Formal and informal resources available for the elderly and disabled; and Non-profit operations, organizations, functions, and challenges.

Skills:

Oral and written communication; Microsoft Office Suite (Word, PowerPoint, Excel); Attention to detail; Use of computers and other office equipment; Reasoning, problem-solving, and organization; Analytical skills; Establishing and sustaining interpersonal relationships; and Organizing and maintaining accurate files and records.

Abilities:

Be present and punctual; Prioritize work and meet deadlines; Work under stressful situations with patience and tact; Teamwork; Administer federal and state-funded programs; Identify workload, be flexible, and prioritize changing workloads; Prepare and maintain accurate records; Establish and maintain effective working relationships with funding agencies, contractors, officer, and employees of the organization; and Maintain confidentiality.

This position will remain open until filled.

Gateway Area Development District is an Equal Opportunity Employer M/F/D/V.

About Gateway Area Development District:

Gateway Area Development District (GADD) is the regional council of government and federally designated Area Agency on Aging and Independent Living, along with the federally designated Economic Development District by the Economic Development Administration, serving Bath, Menifee, Montgomery, Morgan, and Rowan Counties in east-central Kentucky since 1969. GADD is governed by a Board of Directors comprised of elected officials from the counties and communities within the region as well as non-elected citizen members representing the region's social and economic institutions. GADD board and staff are committed to the regional planning, promotion, and coordination of programs for community, infrastructure, economic, and social development.