Job SummaryThe Advantage Case Manager is responsible for managing the care, coordination, and oversight of clientsenrolled in Oklahomas ADvantage Medicaid Waiver Program. The Case Manager ensures that participantsreceive timely, appropriate, and high-quality services designed to maintain independence and preventunnecessary institutionalization. This position collaborates with clinical, operational, and community partnersto ensure regulatory compliance, fiscal responsibility, anLicensed Practical Nurse (LPN) with an active Oklahoma license as verified on the Oklahoma Board ofNursing website

• , with one (1) year of paid professional or technical experience
• providing direct care services
• Paid technical experience may include, but is not limited to: Certified Nursing Assistant (CNA),Certified Medical Assistant (CMA), Certified Home Health Aide (CHHA), or Personal Care Assistant(PCA) experience.

Experience:

Minimum of one (1) year of direct care experience as defined above. At least 35 years of experience in case management, home and community-basedservices, or long-term care coordination preferred. Experience with Medicaid waiver programs, home health, or long-term care servicesstrongly preferred.

Skills:

In-depth knowledge of Oklahoma ADvantage Program and its guidelines Excellent communication, organizational, and problem solving skills Ability to work independently and manage a caseload effectively Strong computer skills and ability to navigave case management software

Transportation:

Reliable transportation and valid and current auto liability insurance. Conduct comprehensive assessments and ongoing reassessments of participants careneeds and eligibility. Develop, implement, and manage individualized service plans consistent with ADvantagewaiver requirements. Monitor and coordinate delivery of waiver services (e.g., therapy, home health, PT/OT/SLP,personal care, environmental modifications, respite, medical supplies). Perform clinical oversight and review, or adjusting services to maintain quality and preventoverutilization. Manage interdisciplinary collaboration with formal and informal support system. Ensure compliance with ADvantage waiver rules, documentation requirements, serviceauthorization, and regulatory reporting. Monitor metrics such as participant outcomes, service utilization, hospital / nursing hometransitions, and participant satisfaction. Provide participant and family education regarding program services, rights, andresponsibilities. Serve as liaison with Oklahoma Department of Human Services / Aging Division, OHCA,and relevant regulatory entities. Participate in internal audits, quality improvement initiatives, and corrective action plans asneeded.

Key Performance Indicators (KPIs) Compliance audit accuracy / error rates Timely development and completion of service plans Participant satisfaction / complaint rates Clean claim / documentation acceptance rates Service utilization relative to budget / cost controlsCore Competencies Medicaid waiver program knowledge (ADvantage) Case management and care coordination Regulatory compliance and documentation accuracy Outcome-driven decision-making Communication and stakeholder relations Interdisciplinary collaboration Problem-solving and resource management