The Case Management Services Manager coordinates all aspects of Case Management in his/her assigned geographical region and is responsible for the overall day-to-day management of assigned programs. Assigned programs include Medical Case Management, PAC Waiver Case Management, FQHC Medical/Non-Medical Case Management, Adult Targeted Case Management.
ESSENTIAL JOB RESPONSIBILITIES
- Coordinates the hiring, training, competency assessment and supervision of assigned staff.
- Coordinates with other departments and coordinates with other agencies as necessary to facilitate the delivery of all types of Case Management and other assigned services.
- Maintains relationships by representing the agency with assigned community groups and organizations at the local and state levels to ensure coordinated service delivery.
- Assists director with marketing and promotional activities of the programs.
Quality Assurance and Performance Improvement
- Establishes as appropriate clinical and administrative procedures required for high quality, effective Case Management at the agency and for other staff as applicable ensuring compliance with all standards of care,.
- Performs an assigned number of Quality Assurance and record reviews directly for Case Management and other assigned services.
- Develops and coordinates the identification, organization and assessment of resources for Medical Case Management, Medicaid PAC Waiver Case Management and other assigned services.
- Responsible for coordinating and managing site visits, monitoring visits, and audits from funders and ensures performance of staff meets established standards to receive positive results.
- Prepares charts for internal and external audits.
- Ensures areas of responsibility adhere to HIPAA and other State, Federal and Local regulations, standards of care and QA measures.
- Manages all improvement of services in assigned areas through utilizing Plan, Do, Check Act Cycle and Every time Checklists.
- Completes monthly productivity reports for assigned programs, reports on deliverables and acts upon emerging problem areas to increase appropriate utilization.
- Coordinates, reviews and monitors all billings, budgets and contracts related to Case Management and other assigned services.
- Ensures all documentation and billing is accurate, timely, legible and complete.
- Ensures productivity is equitably, reasonably and regularly produced by each person within the areas assigned according to the following guidelines:
- Medical Case Managers (Productivity equals 444 units per month, with caseloads of 75-100)
- Non-Medical Case Managers (Productivity equals 444 units per month, wiith caseloads of 75-100)
- Adult Targeted Case Managers (bill on average 6 hours per day)
- PAC Medicaid Waiver (Productivity equals 75 units per month, with caseloads of 75)
- Intake Assistants (Productivity equals 444 units per month with cases assigned according to need)
- Programmatic Development and Support
- Maintains regularly scheduled meetings with staff, logging minutes into electronic records including Ryan White Part A, MAI and Care Resource files.
- Coordinates all training for those within assigned areas by maintaining records of agendas, training materials, attendance and certificates of completions for all formal training..
- Responsible for the billing, control and reporting of monthly bus passes.
- Participates in grant writing and contracts management for the programs.
- Develops, reviews and maintains relevant policies and procedures at a minimum yearly.
- Ensures proper hand washing according to Centers for Disease Control and Prevention guidelines.
- Understands and appropriately acts upon assigned role in Emergency Code System.
- Understands and performs assigned role in agency’s Continuity of Operations Plan (COOP).
- Participates in agency developmental activities as requested.
- Other duties as assigned.
Bachelor’s Degree in Social Work or related field required, Master’s Degree in Social Work or related field preferred. At least four years of case management experience with HIV/AIDS service provider organizations is preferred. At least three yeasrs of supervisory experience are required. Case Management Medicaid Provider Certification is required (including PAC Waiver and Adult Targeted Case Management). Completed application and fingerprinting submitted to supervisor within 30 days of hire and providership obtained within 90 days of hire if not already Medicaid PAC Waiver Provider. Bilingual (English-Spanish/ English-Creole) is highly recommended. Computer knowledge should include Microsoft Word, Excel and Patient Care Systems. Good organizational and team work skills. Excellent communication, decision making and problem solving skills are needed. Ability to work with multicultural and diverse population is required. The responsibility for internal and external contacts is frequent and important. This position supervises Case Managers and other staff as applicable.
SALARY: Commensurate with experience
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