SDS - Case Manager

SUMMARY OF POSITION:

This position is FLSA non-exempt and eligible for overtime. This position is union represented. Provides initial service eligibility and ongoing case management with financial eligibility coordination to individuals needing personal care assistance to promote quality of life, independence, and care in the least restrictive setting. Works with Medicaid payment/ tracking systems, Consumer Assessment and Planning Systems (CAPS), as well as related forms and terminal screens.

Performs position duties in a manner which promotes customer service and harmonious working relationships, including treating all persons courteously and respectfully. Engages in effective team participation through willingness to assist and support co-workers, supervisors, and other work-related partners. Develops good working relationships with division and agency staff and supervisors through active participation in accomplishing group projects as well as identifying and resolving problems in a constructive manner.

Demonstrates positive acceptance of constructive feedback and suggestions to strengthen work performance. Contributes to a positive, respectful, and productive work atmosphere. Regular attendance is required to meet the demands of this job in order to provide necessary services. This position is a Mandatory Reporter by statutory requirement.

• Conducts initial, annual, and ongoing risk assessments and risk mitigation reviews.
• Monitors ongoing cases, adjusting service plans as needed.
• Provides backup support to other social workers and unit staff as directed by supervisor, including protective services.
• Provides relocation planning for nursing facility clients and/or clients requesting transfer to other living situations.
• Assists consumers in requesting and obtaining K-State Plan Ancillary Services and/or Special Needs eligibility.
• Provides crises response and intervention to support consumers care needs and care plan.
• Makes referrals to community resources to support individual care plans.
• Assists consumers through service provision issues and problem solving to resolve issues with providers, services, and/or hours that do not meet the individual’s needs.

• Completes initial service assessment eligibility and ongoing annual service reviews in accordance with Oregon Administrative Rules (OARs).
• Interviews consumers in their own home or care setting to gather personal, social, and medical history information in order to determine and assess person-centered needs, current level of functioning, eligibility,
• preferences, and the need for appropriate referrals.
• Conducts assessment of medical/psycho/social needs for persons needing home and community- based services.
• Completes Consumer Assessment & Planning System document and/or State Plan Personal Care Assessment.
• Determines if services are to be provided by Medicaid. If assigned, completes service eligibility in full, including all necessary paperwork and updating affiliated systems. May refer to the Oregon Project
• Independence (OPI) Case Manager and/or other community service options.
• Reviews and assists consumers with requesting and monitoring Extended Waivered Eligibility.

• Develops service plan to meet service and care needs. Coordinates with hospitals, other health care providers, family, friends, and significant others to ensure comprehensive needs are met, including assisting consumers and/or providers through exceptions processes.
• Establishes specific care plans including hours and specifics of home care and personal care services. Arranges for contractor or consumer-employed provider to provide services for consumer.
• Arranges for Long-term Care Community Nurse (LTCCN) or individual consumer employed contract RN to assess for personal care plans. May complete all paperwork associated with payment authorization process and routes through established office procedures.
• Arranges for Behavioral Support Services and Emergency Response Services to support care planning. May complete all paperwork associated with payment authorization process and routes through established office procedures.
• Monitors ongoing cases and adjusts service plans as needed. Arranges for necessary services such as home delivered meals, transportation, and prior authorized medical.
• Provides resource referral for family caregivers.
• Updates all affiliated service planning…