Waiver Case Manager

We are hiring Waiver Case Managers in the surrounding areas of Louisville, KY.

• Experience working with Aging and/or Disabled Clients
• 6 months minimum knowledge of Medicaid Waiver Process
• Flexible Scheduling
• Earn PTO while working 32+ Hours per Week

At Almost Family Home and Community Based Services, a part of LHC Group, we embrace a culture of caring, belonging, and trust and enjoy the meaningful connections that come from it: for the whole patient, their families, each other, and the communities we serve-it truly is all about helping people. You can find a home for your career here.  

As a Waiver Case Manager, you can expect:

• Flexibility for true work-life balance  
• Opportunities for career growth
• The ability to build trusted patient relationships 
• Employee-focused wellness and support programs 

If you love caring for people and want to strengthen your experience, this is a great opportunity for you.

Job Summary

Coordinates the integration of Case Management / Social Services functions for client's participating in a waiver program in Kentucky. The Case Manager is responsible to lead a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates available services on an ongoing basis to meet the client's health care needs. Acts as a patient advocate, performs staff education related to resource utilization, and discharge planning.

Education and Experience

License Requirements A bachelor's or master's degree in a health and human service field and at least (1) year experience in a health and human service field or the educational equivalent in the field of aging or disability or a master's degree in health or human services field.

• Responsible for performing case management functions for Kentucky Waiver programs.
• Complete timely initial visit to clients to explain waiver program.
• Communicate in a way that ensures the best interest of the client.
• Responsible for identifying the needs of the client and ensure needs are met.
• Educate the client and/or client representative regarding the case management process, personal rights, risks and responsibilities, and available resources.
• Lead the person-centered service planning team and take charge of coordinating and monitoring services through team meetings with all service providers and participants of the client's person-centered service plan.
• Ensure participation of the client and/or client's legal representative in the case management process.
• Assess the quality of services, safety of services, and cost effectiveness of services being provided to the client to ensure the success and efficiency of the person-centered care plan.
• Review and coordinate client's eligibility in Kentucky Medicaid Waiver.
• Ensure reassessment is completed by the Department for Medicaid Services to maintain member eligibility prior to level of care end date.
• Ensure accurate updating of the client's status in the Medicaid Waiver Management Application (MWMA) including (but, not limited to): termination from program, admitted to the hospital or skilled nursing facility, transferred to an alternate waiver program, or relocation of residence.
• Complete all appropriate Medicaid waiver forms and documentation and submit through the Medicaid Waiver Management Application (MWMA).
• Ensure client and/or client representative is provided information about participant direct services at the time of the initial person-centered care plan, at least annually thereafter, and upon inquiry from the client and/or client representative.
• Complete all case notes in the MWMA.
• Maintain Participant Directed Service (PDS) employee paperwork and chart, as applicable.
• Train PDS employees and clients, as applicable.
• Work with PDS Manager to assure client's needs are being met.
• Assure Prior Authorization letters are received for billing.
• Direct waiver referrals, in a timely manner, to the Aging and Disability Resource Center (ADRC) staff.
• Advocate on behalf of the client and family with appropriate community resources.
• Monthly home visits/phone calls to monitor service delivery and progress toward member's goals.
• Work closely with traditional provider agencies, local Department for Community Based Services, Department for Aging and Independent Living, and Department for Medicaid Services.
• Work with clients to solve eligibility issues.
• Monitor client budget to assure client is within guidelines.
• Issue a client corrective action plan if client does not comply with the person-centered service plan, as applicable.
• Provide conflict-free case management or ensure completion of exemption, as applicable.
• Follow all organizational policies and procedures.
• Supports and participates in the Quality and Performance Improvement program.
• Supports and complies with organization's Corporate Compliance program.
• Attends and completes all in-service and education requirements of the organization.
• Completes all other duties as assigned.
• All other duties as assigned.

License Requirements

• A bachelor's or master's degree in a health and human service field and at least (1) year experience in a health and human service field or the educational equivalent in the field of aging or disabilities or a master's degree in health or human services field.

Skill Requirements

• Broad knowledge base of special needs groups, community groups, and service organizations.

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