Case Manager CMA Medical Day Care Services

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Full Time Professional Baltimore City, Baltimore, MD, US

8 days ago Requisition

Case Manager - CMA Medical Day Care Services

Responsibilities:

The Case Manager is responsible for delivering high-quality, person-centered case management services to individuals enrolled in the Medical Day Care Services Waiver (MDCSW). This includes conducting comprehensive assessments, developing Plans of Service (POS), coordinating needed resources, monitoring participant progress, and ensuring all services comply with MDH, COMAR, and LTSS Maryland requirements.

Job Summary:

The Case Manager plays a key role in supporting older adults and individuals with disabilities by coordinating medical, social, and community-based services that promote independence, safety, and quality of life. Case Managers work directly with participants, their representatives, Adult Medical Day Care Centers, Local Health Departments, MAP offices, and community partners to ensure holistic, person-centered care.

Essential functions include:

• Conducting in-person comprehensive assessments, including the Comprehensive Strengths Questionnaire (CSQ), SDOH screening, risk assessments, and person-centered interviews.
• Make initial contact and conduct the first visit within 14 calendar days of receipt of the referral.
• Developing individualized Person-Centered Plans of Service (POS) that reflect participant strengths, needs, goals, preferences, and risks within 20 calendar days of assessment completion.
• Complete the redetermination POS at least 30 days before eligibility expires.
• Ensuring all PCP/POS documents meet MDH documentation standards and are completed within required timelines.
• Providing participants with education on rights, responsibilities, informed choice, RE reporting, and satisfaction surveys.
• Coordinating and linking participants to Medicaid and non-Medicaid services, including AMDC services, behavioral health supports, transportation, housing assistance, caregiver resources, and community/faith-based supports.
• Verify the participants' Medicaid eligibility each month using the Eligibility Verification System (EVS).
• Maintaining ongoing contact with participants through monitoring visits, at a minimum of every 180 days and/or as needed for follow-up.
• Documenting all activities in LTSS Maryland accurately, thoroughly, and on time.
• Identifying risks or changes in participant condition and escalating concerns promptly to the Lead Case Manager or Supervisor.
• Ensuring conflict-free case management by presenting provider options objectively and without influence.
• Report all Reportable Events (RE) within 3 business days, and update the Intervention/Action Plan within 10 business days.
• Supporting participants in resolving service gaps, provider issues, or unmet needs.
• Participating in interdisciplinary meetings with Adult Medical Day Care centers, Local Health Departments, and community partners to coordinate care.
• Complying with COMAR, MDH policies, HIPAA, and EMRC documentation standards.
• Participating in required in-person MDH trainings, refresher trainings, coaching sessions, and supervision meetings.

Case Managers are assigned a manageable caseload (example: approximately 1:35) to support frequent contact, individualized planning, and ongoing monitoring.

Qualifications:

• Passionate about supporting older adults, individuals with disabilities, and vulnerable populations.
• Strong interpersonal skills and ability to engage participants and families in person-centered planning.
• Excellent documentation, organizational, and time-management skills.
• Demonstrated experience in case management, service coordination, medical day care, behavioral health, or related human services roles.
• Knowledge of community resources, SDOH supports, crisis interventions, and referral systems strongly preferred.
• Understanding of COMAR 10.09.61, Medicaid waiver services, and LTSS Maryland is preferred (training will be provided).
• Ability to conduct home visits, in-office assessments, and field-based activities as required.
• Ability to work independently while collaborating with a multidisciplinary team.
• Bachelor’s or Master’s degree in Social Work, Human Services, Psychology, Public Health, Gerontology, or a related field.
• Must pass Maryland CJIS background clearance and comply with Conflict-Free Case Management standards.
• Must complete all MDH-mandated in-person and recurring trainings.