Qualified Professional; QP), I​/DD

Covenant Case Management Services is seeking an energetic and compassionate Qualified Professional (QP) with experience in intellectual and developmental disabilities (I/DD) to support individuals in the Harrisburg area. In this hybrid role, you will help ensure high-quality service delivery, build positive relationships, and advocate fiercely for the people we serve.

• Team Recruitment: Own staffing for your team and caseloads; actively recruit and fill open roles to ensure adequate coverage.

• Caseload Management: Manage a caseload of 25–30 active cases (excluding cases held for coverage). Match staff to cases based on skills, personality, and fit while ensuring timely staffing and strict policy compliance.

• Supervision: Oversee direct care staff to ensure they adhere to CCMS policies and best practices. Lead monthly Direct Support Professional (DSP) supervision meetings and deliver ongoing training.

• Regulatory Compliance: Maintain strict compliance with DHHS/state rules, Medicaid/state waivers, MCO requirements, and CCMS policies. Act as a champion for policy adoption and ethical practice.

• Care Planning: Conduct comprehensive, person-centered assessments; set measurable goals and develop clinically accurate, medically necessary Individualized Support Plans (ISPs).

• Quality Review: Review and approve ISP documentation, assessments, progress notes, and related records. Sign off on new or updated ISPs and coordinate with Medical Records for timely system uploads.

• Utilization Management: Daily review note reports to monitor compliance with staff-completed service notes. Train staff on correct documentation practices, approve compliant entries, and issue required corrections. Monitor underutilized reports and take swift action to optimize service delivery.

• Incident Reporting: Promptly report all incidents to Quality Management (QM) via the internal Incident Reporting (IR) process; fully support IR/IRIS entries for Level 2 and Level 3 incidents.

• Risk Mitigation: Partner with QM to identify risks, recurring incidents, or service gaps. Participate in risk-reduction activities and assist in developing, implementing, and monitoring Plans of Correction (POC).

• Audit Readiness: Lead and participate in internal audits and CARF-related activities. Collaborate with QM, Clinical Directors, and Medical Records to prepare documentation and regulatory responses for auditors. Ensure ongoing, regulation-ready state across all assigned programs.

• Financial Accountability: Review data and billing for precision and compliance. Monitor authorization status monthly, completing service limit sheets for every authorization received to support utilization management.

• Consents: Secure valid consents from individuals and legally responsible persons, supporting annual client consent updates when necessary.

• Stakeholder Relations: Build trusted relationships with MCOs, collaborating agencies, families, and CCMS leadership. Proudly represent CCMS in community activities and interagency meetings.

• Administration: Manage ongoing administrative workflows—including authorizations, progress reports, and documentation reviews—to guarantee completely regulation-ready records.

• Skill Building: Train staff members thoroughly on individual client needs, ISP requirements, and programmatic benchmarks. Lead staff development initiatives to maximize policy compliance.

• Accountability: Provide guidance and clear accountability metrics for DSP performance. Administer corrective actions in accordance with company policy and facilitate the…