Case Management Supervisor

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.

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.

• 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.

Involves developing and maintaining a Plan of Care for PDS and Traditional Waiver clients, completing required home visits and telephone calls, and data entry.

• 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…