Qualified Professional - IDD Population

SUMMARY :

This staff person is responsible for overseeing all Innovations Waiver services in conjunction with the MCOs and other stakeholders. This includes maintaining a caseload of consumers at The Unique Caring Network, Inc. while assisting with maintaining the requirements for all reauthorization and national accreditation. The responsibilities as outlined below :

JOB RESPONSIBILITIES :

• Provide assistance with Medical Records securing all pertinent records (court documents, birth certificates, social security card) for individuals served by the agency.
• Participate in Individual Service Plan (ISP) meetings for consumers on your assigned caseload making service-related recommendations as needed and maintaining a person-centered approach.
• Ensure all established requirements are met for case plans, case reviews, home visits and supervision plans to maintain excellent consumer care.
• Accurate and timely completion of Critical Incident Reports according to state mandates and submitted, as per criteria to IRIS within 72 hours of the incident.
• Ensure that the state-mandated home visits are completed, and any additional if warranted, to maintain optimum quality of service delivery.
• Ensure that all case manager / QP paperwork and documentation are submitted to the Director according to the established time frame and date.
• Complete consistent review of data in the assigned computer billing system to ensure timely documentation of service delivery notes.
• Weekly review and submission of completed data to the Payroll Specialist for billing processing according to established timelines.
• Remain current on changes with the Innovation Waiver and suggest appropriate program changes as indicated.
• Ensure compliance with applicable federal, state and agency statutes, administrative codes, policies and procedures.
• Provide support as a First responder to any questions or problems with the AFL providers on your caseload with complete compliance.
• Participate actively in Client Rights Committee bringing violations of clients’ rights.
• Maintain optimum communication with providers, stakeholders and referring agencies ensuring that all information needed for effective performance is received.
• Attend pertinent training offered by our agency, contracted agency, MCO or MCO affiliate to ensure that you are equipped with the latest information needed to perform your job at optimum.
• Remain current with changes in MCOs’ requirements and that of Waiver.
• Observe and maintain confidentiality as mandated in HIPAA regulations and that of UCF with total compliance.
• Provide support to Medical Records staff with Quality Assurance activities including case file reviews on a quarterly basis.
• Provide guidance to direct care staff by coaching, motivating, training and developing activities.
• Provide necessary reports and paperwork in a timely manner.
• Respond to all crisis calls, on caseload, during work hours whether in the home, community or day program.
• Provide oversight with the hiring and of direct staff for the AFL homes on your caseload.
• Work closely with Compliance Specialist to ensure AFL homes remain in optimum standards according to state requirements allowing for a safe environment and providing initial walk-through for licensure.
• Coordinate efforts with the Director to ensure the provision of regular training to new and existing staff.
• Provide all providers on caseload with annual evaluations with 100% accuracy
• Complete a minimum of 20 hours of in-service training hours each year of employment. These hours must include the mandatory areas of Medication Administration, Seizure Management, Blood Borne Pathogens, Health & Safety & Community Awareness, CPR / FA, and EBPI.
• Work in collaboration with Training Coordinator to meet the training needs of Providers on diagnoses and areas of need and increase understanding of types of behaviors to expect.
• Prepare and conduct Provider annual performance reviews and initiate disciplinary actions when appropriate according to agency policies and procedures.
• Ability to prepare and present cohesive information to staff and management.
• Perform other duties as assigned.

REQUIREMENTS :

ADDITIONAL REQUIREMENTS :