Lead Case Manager

Lead Case Manager

Area Agency on Aging

Department of Human Services

Hourly Wage: $29.70/Regular/Full-Time

Acts in a technical assistance, information resource and training role for case managers. Works cooperatively with program manager to ensure local service delivery meets expectations. Provides quality assurance oversight for all assigned aspects of contracted, Medicaid-funded in-home case management. Responds to payment system, Quality Assurance, Fair Hearings requirements, and ALTSA requests to ensure that all State standards are met. Collaborates, as a service delivery team providing a wide spectrum of necessary services to client. Maintains all funding source requirements for service delivery to clients. Provides follow-up to the state funding agency on program policy or payment discrepancy issues. Monitors appropriate program and budget reports. Compiles reports as required. Collaborates with Contract Manager to conduct annual home care agency monitoring. Provides monthly training on Long Term Care Manual Chapters per Chapter 23A. Provides case management for clients.

Examples of Work Performed:

Direct Client Service:

Provides supportive functions for the client, including client advocacy, assistance, consultation, education, family support, and crisis intervention.

Conducts an assessment that evaluates client's cognitive, behavioral, and functional abilities by utilizing the appropriate assessment tool, such as Washington State Comprehensive Assessment and Reporting & Evaluation (CARE), GetCare (aka CLC), or other similar assessment tools. Determines need and level of supports for long term care services; reassesses and monitors as needed and per policy.

In collaboration with the clients and supports, develops a safe and appropriate client-centered service plan, including use of case consultation for development.

Evaluates for in-home services and providers; implements service plan by making arrangements with informal supports and/or appropriate referrals to service providers; enters and monitors all authorization for service.

Provides long-term, ongoing case management and monitoring to ensure service plan is functioning as intended and meets the needs of the clients; assists with transition planning for clients requiring a higher level of care.

Documents case management activities in appropriate platform (e.g., GetCare and CARE) according to policy.

Conducts termination planning and implementation when client situation stabilizes and/or client is no longer in need of case management services.

Works collaboratively with multi-disciplinary team, including nurses, care coordinators, other case managers, and program specialists.

Develops and maintains connections with community agencies, organizations, and individuals (e.g., potential caregivers) that could provide support to YN AAOA programs or individual older persons, including implementation of education and outreach strategies.

Fosters communication between client's providers (i.e., primary care provider, medical specialists, etc.) and provider networks (i.e., behavioral health organization, home care agencies, etc.)

Facilitates and encourages clients use of peer supports and/or participation in appropriate support groups and self-care.

Participates in community liaison activities which include, providing information services regarding older adults to service groups, senior centers, and gatekeepers.

Lead Responsibilities

Provides initial training and support to new case management staff including shadowing home visits and assessments and helping management create and maintain up-to-date training tools and tracking logs.

Develops and implements public education and provider training sessions, and supports management in staff meetings, as requested and appropriate.

Coordinates incoming and outgoing Title XIX cases with appropriate staff from both DSHS Home and Community Services and other Area Agency on Aging offices. Performs initial review of cases and assigns cases to case managers based on skill level and existing case load. Monitors and reviews case files for program compliance, quality, accuracy, and completeness.

Provides other case management support functions (e.g., client advocacy, assistance, consultation, networking, family support, and crisis intervention).

Coordinates nursing services referrals with other staff and assures that nursing services are implemented in compliance with program quality assurance standards, policies, and procedures.

Collaborates with ALTSA Quality Assurance Team in the completion of compliance reviews per LTC Chapter 23A Quality Assurance.

Follows and is responsible for the ALTSA Quality Assurance (QA) process annually; assists in the follow up and

remediation responses.

Identifies staff training needs and provides or arranges training, in consultation with management, which specifically

focuses on programmatic core requirements, compliance, and competencies as identified by management and the QA process itself.

Assists with the tracking and escalation of second tier CDWA issues as needed.

Performs in the capacity of Administrative Hearing Coordinator for other Case Managers within the department.

Performs in the capacity of Public Disclosure Coordinator per Long Term Care Manual Chapter 2.

Attends staff meetings, case reviews, and inter-agency staffing, etc.

Is responsible for cases if a case manager is out on leave.

Coordinates with the Contract Manager to assist with completing annual home care agency monitoring in accordance with DSHS AAA Policies and Procedures Manual, Chapter 6.

Provides information and assistance to case managers and acts in a problem-solving capacity for case management issues.

Develops and maintains professional working relationships with the general public, Tribal, and State agencies.

Participates in local, state, and regional meetings as required and as time permits. Participates in virtual meetings and training webinars.

Enters payment system data in a timely and accurate manner.

In preparing correspondence and narrative reports, utilizing working knowledge of the correct and proper application of basic grammar, punctuation, and spelling.

Remains informed of new policy developments and keeps supervisor apprised of any changes that may affect procedures.

Completes monthly reports and keeps diligent records of all client interaction.

Ensures confidentiality is maintained and adhered to.

Other duties as assigned.

Knowledge, Skills and Abilities:

Knowledge of AAOA program mission, policies, and services.

Knowledge of various cultures prevalent within YN AAOA PSA 10.

Knowledge of standard filing practices and procedures, including data entry and records management.

Knowledge of proper and correct application of grammar, punctuation, and spelling in preparing correspondence and narrative reports.

Working knowledge of Health Information Portability and Accountability Act (HIPAA).

Knowledge of available resources within the community for medical and social services.

Knowledge of proficiency in computer use, specifically Microsoft Office, Adobe.

Knowledge of tribal administrative policies and procedures.

Knowledge of Yakama Nation governmental organization.

Skills in use of personal computers, software, and general office machines.

Ability to establish and maintain effective working relationships with others.

Ability to manage multiple complex projects and tasks while completing deadlines.

Ability to communicate effectively, professionally, both orally and in writing, with all levels of personnel including employees, supervisor, elected officials, etc.

Ability to demonstrate a high degree of personal integrity and be able to maintain strict confidentiality.

Ability to work independently and productively with minimal supervision.

Minimum Requirements:

Successful completion of four (4) years of college-level courses in Social Sciences, OR

Any specialized work experience, specialized training, and college courses that meet the requirements of the position.

Must pass a pre-employment background check.

Must possess a valid Washington State Driver's License with the ability to obtain a Yakama Nation Driving permit.

Required to pass a pre-employment drug test.

Preferred Requirements:

Master's degree in social sciences

Enrolled Yakama Preference, but all qualified applicants are encouraged to apply.

Salary : $30