What are the responsibilities and job description for the Community Care Worker III/Case Manager position at Texas Health and Human Services?
Date: Dec 31, 2024
Location:
ARLINGTON, TX
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Community Care Worker III/Case Manager
Job Title: Community Care Worker III (CT)
Agency: Health & Human Services Comm
Department: MC Prog Supp & Int Mgmt - Reg
Posting Number: 1852
Closing Date: 01/30/2025
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Group: TEXAS-B-13
Salary Range: $2,953.25 - $3,659.41
Shift: Day
Additional Shift: Days (First)
Telework: Part-Time
Travel: Up to 10%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: ARLINGTON
Job Location Address: 2561 MATLOCK RD
Other Locations: Grand Prairie; Abilene; Arlington; Houston
MOS Codes:
42SX,4C0X1
Brief Job Description:
Program Enrollment and Support (PES) under the Medicaid CHIP Services Division (MCS) is searching for new team members to join our Program Support Unit (PSU). PSU is responsible for facilitating the STAR Kids Medically Dependent Children Program (MDCP) and STAR PLUS Home and Community Based Services (HCBS) eligibility and enrollment process for applicants and members. Services under these programs assist managed care members with maintaining their independence in the community.
PSU staff perform moderately complex tasks related to Medicaid managed care Long Term Services and Supports (LTSS). Work involves frequent telephone contact with the public, members and their families and staff from external organizations such as Managed Care Organizations (MCOs), PSU staff will also coordinate with various internal HHSC departments such as Managed Care Compliance and Operations (MCCO) and Medicaid for the Elderly and People with Disabilities (MEPD).
Upon successful completion of training, PSU staff will have knowledge of program operational policies, procedures, and software. Duties include assisting applicants with the eligibility and enrollment processes for Medicaid waiver programs, approve and deny eligibility for Medicaid waiver programs, provide assistance to members transitioning from a nursing facility to the community, validate and enter waiver eligibility records in authorization systems, notify members of Medicaid waiver program eligibility, manage fair hearing requests for program denials, transfer members between waiver programs, and coordinate the age out process for individuals enrolled in a children’s Medicaid program. This position requires extensive computer usage, research and comprehension of program policies and procedures to successfully process cases according to PSU policy and procedures. Staff work under general supervision with moderate latitude for initiative and independent judgment.
Essential Job Functions (EJFs):
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Develop, coordinate, and explain waiver programs to applicants and members. Authorize or deny waiver services, send approval and denial notices. Validate eligibility in appropriate systems. Register waiver program eligibility in authorization system, authorize MCOs to begin approved services. Coordinate with MEPD staff for enrollment in Medicaid. This includes activities for members transitioning out of nursing facilities to the community. (50%)
Perform interest list activities such as confirming accurate contact information, mail enrollment packets, determine appropriate MCO enrollment and verify applicants desire to enroll in a Medicaid waiver program. (10%)
Perform age out activities by coordinating activities related to transitioning individuals from a children’s program to an adult waiver. (10%)
Research and trouble-shoot case actions and document delay reasons. (5%)
Handle continuum of care issues related to waiver members who have been disenrolled or transferred in or out of managed care service areas and are experiencing a gap in services. This could include coordinating with MCO’s. (10%)
Assist denied Medicaid waiver members to file a fair hearing with the state. Track and monitor the fair hearing processes through to the decision. (5%)
Handle other duties such as reports for monitoring program operations, research and resolve errors in enrollment and make referrals to MEPD for members who lose Supplemental Security Income (SSI) eligibility. (10%)
Knowledge Of:
Knowledge, Skills and Abilities (KSAs):
N/A
Initial Screening Criteria:
Telework opportunities are available in accordance with business needs. Telework privileges are also subject to change under MCS direction.
Only applications with the job experience completed on the application will be considered.
SALARY NOTE: The posted salary range reflects the minimum and maximum allowable by state law. Any employment offer is contingent upon available budgeted funds. The salary offered will be determined in accordance with budgetary limits and the requirements of HHSC.
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, And Veterans:
Military occupation(s) relating to the initial selection criteria and registration or licensure requirements for this position may include those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information, please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA Accommodations:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
Pre-Employment Checks And Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, And Veterans:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
Pre-Employment Checks And Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Nearest Major Market: Arlington Texas
Nearest Secondary Market: Dallas
Location:
ARLINGTON, TX
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Community Care Worker III/Case Manager
Job Title: Community Care Worker III (CT)
Agency: Health & Human Services Comm
Department: MC Prog Supp & Int Mgmt - Reg
Posting Number: 1852
Closing Date: 01/30/2025
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Group: TEXAS-B-13
Salary Range: $2,953.25 - $3,659.41
Shift: Day
Additional Shift: Days (First)
Telework: Part-Time
Travel: Up to 10%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: ARLINGTON
Job Location Address: 2561 MATLOCK RD
Other Locations: Grand Prairie; Abilene; Arlington; Houston
MOS Codes:
42SX,4C0X1
Brief Job Description:
Program Enrollment and Support (PES) under the Medicaid CHIP Services Division (MCS) is searching for new team members to join our Program Support Unit (PSU). PSU is responsible for facilitating the STAR Kids Medically Dependent Children Program (MDCP) and STAR PLUS Home and Community Based Services (HCBS) eligibility and enrollment process for applicants and members. Services under these programs assist managed care members with maintaining their independence in the community.
PSU staff perform moderately complex tasks related to Medicaid managed care Long Term Services and Supports (LTSS). Work involves frequent telephone contact with the public, members and their families and staff from external organizations such as Managed Care Organizations (MCOs), PSU staff will also coordinate with various internal HHSC departments such as Managed Care Compliance and Operations (MCCO) and Medicaid for the Elderly and People with Disabilities (MEPD).
Upon successful completion of training, PSU staff will have knowledge of program operational policies, procedures, and software. Duties include assisting applicants with the eligibility and enrollment processes for Medicaid waiver programs, approve and deny eligibility for Medicaid waiver programs, provide assistance to members transitioning from a nursing facility to the community, validate and enter waiver eligibility records in authorization systems, notify members of Medicaid waiver program eligibility, manage fair hearing requests for program denials, transfer members between waiver programs, and coordinate the age out process for individuals enrolled in a children’s Medicaid program. This position requires extensive computer usage, research and comprehension of program policies and procedures to successfully process cases according to PSU policy and procedures. Staff work under general supervision with moderate latitude for initiative and independent judgment.
Essential Job Functions (EJFs):
Attends work on a regular and predictable schedule in accordance with agency leave policy and performs other duties as assigned.
Develop, coordinate, and explain waiver programs to applicants and members. Authorize or deny waiver services, send approval and denial notices. Validate eligibility in appropriate systems. Register waiver program eligibility in authorization system, authorize MCOs to begin approved services. Coordinate with MEPD staff for enrollment in Medicaid. This includes activities for members transitioning out of nursing facilities to the community. (50%)
Perform interest list activities such as confirming accurate contact information, mail enrollment packets, determine appropriate MCO enrollment and verify applicants desire to enroll in a Medicaid waiver program. (10%)
Perform age out activities by coordinating activities related to transitioning individuals from a children’s program to an adult waiver. (10%)
Research and trouble-shoot case actions and document delay reasons. (5%)
Handle continuum of care issues related to waiver members who have been disenrolled or transferred in or out of managed care service areas and are experiencing a gap in services. This could include coordinating with MCO’s. (10%)
Assist denied Medicaid waiver members to file a fair hearing with the state. Track and monitor the fair hearing processes through to the decision. (5%)
Handle other duties such as reports for monitoring program operations, research and resolve errors in enrollment and make referrals to MEPD for members who lose Supplemental Security Income (SSI) eligibility. (10%)
Knowledge Of:
Knowledge, Skills and Abilities (KSAs):
- Medicaid waiver programs, policies, procedures, and eligibility processes preferred.
- Community and government service delivery systems preferred.
- STAR PLUS Home and Community Based Services (HCBS) program, Medically Dependent Children Program (MDCP), or Intellectual or Developmental Disabilities (IDD) - Long-term Care programs and services preferred.
- Computer equipment and software including Outlook, Word, and Excel preferred.
- State software such as Texas Integrated Eligibility Redesign System (TIERS), Service Authorization System Online (SASO) or the Texas Medicaid & Healthcare Partnership (TMHP) Long Term Care Online Portal (LTCOP) preferred.
- Communicating effectively orally and in writing preferred.
- Managing stress in high-profile situations while maintaining a professional demeanor preferred.
- Identifying systemic problems and ways to resolve those problems preferred.
- Multi-tasking under pressure preferred.
- Managing a workload to meet goals, objectives, and time limits preferred.
- Customer service preferred.
- Convey instructions and explanations to individuals and key parties, to negotiate available services, and to train others preferred.
- Operate computer equipment and be proficient in the use of Outlook, Excel, Word, as well as the ability to gain a general understanding of various state software programs, e.g., Texas Integrated Eligibility Redesign System (TIERS), Service Authorization System Online (SASO) and Community Services Interest Lists (CSIL).
- Identify potential problems and act proactively to prevent the problem preferred.
- Establish priorities according to relative importance and deadlines, set goals and manage time efficiently preferred.
- Interpret complex policy and procedure preferred.
- Gather, assemble, correlate, and analyze facts to devise solutions to problems preferred.
- Develop reports based on research and analysis preferred.
- Perform duties with minimal supervision.
- Understand new or changed information and to effectively relay that information to others preferred.
N/A
Initial Screening Criteria:
- High School Diploma or GED required.
- Prefer experience with case management.
- Prefer experience in a position requiring time management skills.
- Prefer experience with complex policy interpretation requiring good judgement.
Telework opportunities are available in accordance with business needs. Telework privileges are also subject to change under MCS direction.
Only applications with the job experience completed on the application will be considered.
SALARY NOTE: The posted salary range reflects the minimum and maximum allowable by state law. Any employment offer is contingent upon available budgeted funds. The salary offered will be determined in accordance with budgetary limits and the requirements of HHSC.
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, And Veterans:
Military occupation(s) relating to the initial selection criteria and registration or licensure requirements for this position may include those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information, please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA Accommodations:
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.
Pre-Employment Checks And Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, And Veterans:
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
Pre-Employment Checks And Work Eligibility:
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Nearest Major Market: Arlington Texas
Nearest Secondary Market: Dallas
Salary : $2,953 - $3,659
