Epd Case Manager - Washington, United States - The Family Wellness Center

Description

*We are looking for applicants who are ready to work and applicants who hold a LICSW,LISW,LGSW,& RN license in Washington, DC**Licensed Case Manager**
General Job Position:Licensed case manager to provide home and community-based waiver case management services to the elderly or individuals with physical disabilities who have been determined eligible by the Dept of Health Care Finance (DHCF) prior to the receipt of services; and must be recertified on an annual basis. Elderly refers to the recipients who are 65 years or older. Individuals with physical disabilities are adults age 18 years and older.

Home
- and community-based waiver services must be provided under a written individualized service plan (PCP) for each recipient based on an assessment of the recipient's health and welfare needs.


Duties & Responsibilities:

• Conduct monthly telehealth visit, and provide screenshot of telehealth call to validate visit occurred.

After COVID-19 health crisis restrictions have been lifted resume monthly face to face visit. Complete comprehensive assessment of the recipient's medical, social, and functional status to include obtainment of level of care determination and financial eligibility documentation; within forty eight hours (48 hrs)of receiving the EPD waiver

• Conduct financial and functional eligibility screening, contact, or interaction with the recipient's authorized representative
• Determine and develop a specific written Person Centered Plan (PCP) for each recipient within ten (10) days of receiving the referral in collaboration with an interdisciplinary team of professionals and including the recipient or authorized representative, family members, friends, providers of health related services, recipient's physician, and legal guardian, where appropriate, in establishment of the service plan
• Present the PCP (including goals, service providers, frequency, and duration of services) to the recipient or representative for acceptance
• Submit the PCP to DHCF for review and approval
• Following the approval of service from the DHCF, the case manager shall followup promptly with the selected providers of services to ensure that all services are in place, and that the quantity and quality of services are sufficient to meet the identified needs of the recipient.
• Ensure that the recipient is given free choice of all qualified providers of each service included in his or her written PCP
• Assist the recipient with securing necessary physician orders when required for the initiation of any service
• Assist the recipient with initiating service provision, confidentiality, and measure the recipient's progress against the PCP; and providing telephone reassurance and friendly visiting to recipients as part of the case management program
• Conduct a quarterly review of the recipient's PCP to include the following documentation as part of the complete synopsis of the recipient's care and outcomes for a defined period:

(a) Utilization of services

(b) Communication with other providers regarding the recipient's goals and progress

(c) Identification and resolution of problems; and

(d) Referrals or linkages to community resources

• Assist the recipient in gaining access to needed Medicaidfinanced services and all other needed supports (for example, medical, financial, counseling, housing, adult day care, and personal assistance) that are necessary to maintain the recipient in the community
• Coordinate all waiver services for the recipients so that services provided to recipients are delivered in a safe, timely, and costeffective manner; provide supportive counseling to the recipient and family as appropriate; and address and resolve identified problems
• Coordinate and monitor necessary and appropriate services in a timely manner (including twentyfour (24) hour crisis coverage) for the waiver recipient as specified in the recipient's PCP
• Provide information about nonMedicaid programs and services for which the recipient might be eligible; refer the recipient to the proper service as necessary; and provide assistance to the recipient in gaining public benefits and linkages to community resources
• Document monthly inhome visits and telephone contacts
• Review and approve the PCP of the direct care and other service providers in a timely manner and maintain copies in the recipient's record
• Ensure the provision of supplies and equipment for use in the recipient's care;
• Provide supportive counseling to the recipient and family, as appropriate;
• Ensure the costeffectiveness of the recommended waiver services
• Coordinate multiple services or providers; and provide ongoing assessment of the recipient's continued appropriateness for participation in the waiver program
• Provide ongoing monitoring of the implementation of PCP to ensure quality of care and service provisions;
• Ensure that the recipient obtains annual (and as needed) level of care certification, and ensure that all waiver docu