Case Manager

Job Purpose:

Responsible for overseeing activities of Personal Care Providers within the Home and Community Based Services (HCBS) and Private Pay Programs in Huerfano County in accordance with Medicaid Volume 8 and Colorado Department of Public Health and Environment Chapter XXVI regulations. The Case Manager will work closely with the Lead Case Manager and Care Services Director for day-to-day management of the program.

Duties and Responsibilities:

• Maintain strict confidentiality concerning all client information, personnel information, and proprietary corporation information.

• Employee must have a working knowledge of all Medicaid State funded program requirements as outlined in Volume 8 and/or Chapter XXVI, as applicable.
• Employee must have a working knowledge of SCCOG Policies and Procedures.
• Responsible for receiving daily reports from Case Managers on client and provider related issues and reporting areas of concern to Care Services Director.
• Responsible for assisting with oversight of the hiring, firing, and disciplinary process of Personal Care Providers; submitting employee information to HR and payroll for processing.
• Responsible for orientation and training and enforcement of skills training and demonstration of skills proficiency of new employees in the HCBS and Private Pay programs.
• Responsible for administrating quarterly mandatory trainings including presentation, prepping, certificate completion, and updating CareWhen and personnel files.
• Responsible for completing annual performance evaluations for each Personal Care Provider.
• Responsible for completing initial assessment of new client referrals, creating client care plans, and entry of client data into CareWhen software program.
• Responsible for monitoring and supporting program including client quarterly visits, updating and revising client care plans, and follow with any issues/situations needing attention with the Department of Human Services (DHS) Case Workers.
• Responsible for the day to day operations of client care and provider issues including but not limited to Critical Incident and Occurrence reporting.
• Responsible for routine client file maintenance including verifying that all client records have valid Prior Authorization Request (PAR) in place for service, client’s staff assignments adequately address all requirements of the PAR, monthly hours are posted correctly, client timesheet documentation is filed monthly, and all HIPAA documentation and disclosure information is present in files and chart setup. This includes chart breakdowns when clients discharge from program and thinning of active charts.
• Provider are completed by Case Managers in a timely manner prior to review by the Care Services Director.
• Responsible for ensuring timesheets are available for payroll, copying all documentation pertaining to HCBS, Private Pay, and Veteran’s Affair programs.
• Responsible for filing in both client and personnel files.
• Responsible for semi-monthly payroll timesheet processing including calculations of provider hours, completion of visits, calculating billing units, and CareWhen software reconciliation.
• Responsible for completing required billing/payroll reports for the Care Services Director.
• Responsible for participating in Care Services Quality Management Team monthly meeting; assist Care Services Director with reporting requirements; and ensure program meets requirements.
• Will work cooperatively with the Huerfano County Department of Human Services Caseworkers and participate in the Huerfano County Adult Protection team on behalf of SCCOG Care Services program.
• Must have knowledge in all SCCOG programs in order to assist administrative staff with telephone coverage, information and referral services, and access to other programs administered through the South Central Council of Governments.
• Maintains a commitment to SCCOG vision by fostering a work culture that embraces teamwork, independent thinking, and high degree of co-worker support and respect.
• Must attend any recommended educational sessions as instructed by Care Services Director or Executive Director to enhance the effectiveness of the Care Services Programs. Training may include but is not limited to training offered by the Department of Health Care Policy and Finance (HCPF), National Association of Home Care and Hospice (NAHC), Colorado Department of Public Health and Environment (CDPHE), and Private Duty Home Care Association (PDHCA).
• This position requires local, regional, and occasional statewide travel.
• Other duties as assigned by Lead Case Manager, Care Services Director or Executive Director.

Minimum Requirements:

• Bachelor’s Degree in applicable field of social services, business administration, health care services, hospital, medical clinic, or home health; or combination of training, education, and experience that is equivalent to the employment standard listed above and that provides the required knowledge and abilities
• Excellent oral and written communication skills
• Demonstrated leadership ability
• Advanced computer skills including Microsoft Office Suite
• Knowledge and experience in healthcare setting such as Social Services, Nursing Home, Home Health or Hospital preferred
• Appreciation and understanding of rural communities and an interest in working with people in a rural environment
• Valid Colorado Driver’s License with acceptable driving record
• Vehicle insurance and access to motor vehicle
• Employee must pass required background and CAPS checks as required for the position
• Must provide proof of COVID-19 and Influenza vaccination, as requested

Working Conditions

This job operates in a professional office environment. This role routinely uses standard office equipment including, but not limited to computers, phones, photocopiers, electronic postage meter, filing cabinets and fax machines.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.

The employee is occasionally required to sit, climb, balance, stoop, kneel, crouch or crawl. The employee must frequently lift and move up to 20 pounds and occasionally lift and move objects up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Direct Reports

Personal Care Provider

Note: This description is not intended and should not be construed, to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with this job. It is intended to be a reflection of the principal job elements.