EPD Waiver Case Manager

Job Title:

Licensed Case Manager Position Summary The Licensed Case Manager provides home- and community-based waiver case management services to elderly individuals (age 65 and older) and adults (age 18 and older) with physical disabilities who have been determined eligible by the Department of Health Care Finance (DHCF). Services are delivered in accordance with DHCF regulations and must be recertified annually. The Case Manager is responsible for assessing recipient needs, developing and monitoring individualized Person-Centered Plans (PCP), coordinating waiver and non-waiver services, and ensuring the health, safety, and welfare of recipients in the community. Duties and Responsibilities Assessment and Eligibility Conduct face-to-face visits and complete comprehensive assessments of recipients' medical, social, and functional needs within 48 hours of receiving the EPD waiver referral. Obtain and review level-of-care determinations and financial eligibility documentation. Conduct financial and functional eligibility screenings. Maintain contact with recipients and/or authorized representatives. Person-Centered Planning (PCP) Develop a written individualized PCP within 10 days of referral in collaboration with an interdisciplinary team, including the recipient, authorized representative, family members, providers, physicians, and legal guardians as appropriate. Present the PCP to the recipient or authorized representative for review and acceptance. Submit the PCP and any amendments to DHCF for review and approval. Review and approve PCPs submitted by direct care and service providers and maintain documentation in the recipient's record. Service Coordination and Monitoring Coordinate all waiver services to ensure safe, timely, cost-effective, and appropriate service delivery. Ensure recipients are informed of and provided free choice of qualified service providers. Assist recipients in selecting approved providers and securing required physician orders. Initiate and monitor service implementation following DHCF approval. Conduct monthly face-to-face visits (or more frequently as needed) and document monthly in-home visits and telephone contacts. Conduct quarterly PCP reviews , documenting: Service utilization Provider communication Problem identification and resolution Referrals and community linkages Ongoing Support and Advocacy Provide supportive counseling to recipients and families as appropriate. Assist recipients in accessing Medicaid and non-Medicaid services, including medical, housing, financial, counseling, adult day care, and personal assistance services. Provide telephone reassurance, friendly visiting, and crisis intervention, including 24-hour emergency coverage when required. Ensure provision of necessary supplies and equipment. Quality Assurance and Compliance Monitor quality of care and service provision to ensure compliance with the PCP. Review and respond to weekly audits. Complete accurate care coordination documentation in DC Care Connect . Ensure annual level-of-care recertification and submit all required waiver documentation to DHCF 60 days prior to certification expiration. Develop and implement utilization review plans to prevent duplication of services and ensure cost-effective care delivery. Approve and submit requests for changes, additions, or terminations of services using the "Request for Change in Services" form. Serve as the sole authority to admit, modify services, or discharge recipients from the waiver program. Reporting Report directly to the Program Director. Preferred Qualifications Current professional licensure. Master's degree in Social Work, Psychology, Counseling, Rehabilitation, Nursing, Gerontology, Sociology, or a related field. Minimum of one (1) year of experience working with elderly individuals or adults with physical disabilities. Excellent oral, written, and interpersonal communication skills. Strong organizational and time-management skills. Knowledge of Case Net preferred. Ability to pass all required background checks, including criminal background, drug screening, child protection registry, and metropolitan police clearance. Must be free of active tuberculosis and communicable diseases; documentation of Hepatitis vaccination acceptance or declination required.

Signature:

________________________________

Date:

______________________

Job Type:

Contract Pay:

$90.00 - $120.00 per month

Experience:

Case management: 7 years (Required) Home health: 3 years (Required)

License/Certification:

LICSW,LISW,RN,LGSW,OR LPN

( must be valid in Washington, DC) (Required)

Work Location:

In person