RN Case Manager

Job Description

Job Description

Salary: $55,350.00-$73,800.00

SUMMARY DESCRIPTION:

The RN Case Manager is responsible for implementation of the Technology Assisted (TA) Waiver for Adults under the Medicaid Waiver Home and Community-based Services Program within the SARPC area and surrounding counties following specific requirements as set out in Medicaid Waiver guidelines.

SUPERVISORY CONTROLS:

Receives general supervision from the Medicaid Waiver Coordinator. Supervisor sets the overall objectives and employee and supervisor, in consultation, develop the deadlines, projects, and work to be done; employee is responsible for planning and carrying out the assignment; and work is reviewed only from an overall standpoint.

RESPONSIBILITIES AND DUTIES:
1. Assess and manage ventilator dependent and/or homebound clients who are eligible and active on the TA Waiver Program.
2. Work with DME providers, physicians offices and family members to procure necessary medical equipment for clients on the TA Waiver; facilitate needed repairs on said equipment and devices; and is involved in the acquisition of medications approved through the TA Waiver.
3. Authorize contractors to initiate services after receiving notification of approval from Alabama Medicaid Agency, and forward appropriate copies of assessments, care plans, and service authorization forms to the respective contractors.
4. Develop, monitor, and revise clients care plan in coordination with client/caregiver to fit the needs of the client. Conduct monthly visits to clients homes and evaluate the services being provided by the Waiver Programs to ensure the services are appropriate, adequate, and of acceptable quality. Prepare case notes of visits and evaluations for documentation to be placed in case files.
5. Conduct yearly redetermination assessments on clients as outlined in the Waiver guidelines and complete appropriate forms in order to meet requirements prescribed by the Alabama Medicaid Agency.
6. Compose and maintain the following reports as necessary: HCBS Program Case Management Activity Record, Case Managers Daily Time Logs, and Respite Hours Logs.
7. Make monthly face to face visits to TA Waiver Clients
8. Other duties as assigned

KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
1. Knowledge of social work programs and processes preferred.

2. Knowledge of community resources and support network available to clientele served.
3. Knowledge of Health Insurance Portability and Accountability Act (HIPAA).
4. Knowledge of Insurance, including Medicaid State Plan, Medicare, Private Insurance, and waiver programs.
5. Excellent communication skills, both oral and written.
6. Ability to relate to the elderly and their unique problems.
7. Knowledge and ability to operate office equipment including telephone, copy machine, fax machine, computer, and calculator.
8. Knowledge and ability to do basic arithmetic.
9. Ability to read and interpret guidelines and regulations and apply them to the job.
10. Bachelor of Science in Nursing (BSN) from an accredited School of Nursing and licensed as a Registered Professional Nurse (RN) in the State of Alabama Board of Nursing in accordance with the Code of Ala. Section 34-21-21.
11. At least two (2) years work experience as a RN.
12. A valid drivers license and a good driving record.

WORK CONDITIONS:
Some work is sedentary. The employee may sit comfortably to do the work. However, there may be some walking; standing; bending; carrying of light items such as papers, books, small parts; driving an automobile, etc. Some work requires regional travel to client locations. This may require some physical exertion such as long periods of standing; walking over rough, uneven, or rocky surfaces; recurring bending, crouching, stooping, stretching, reaching, or similar activities; recurring lifting of moderately heavy items such as record boxes. This position requires driving on a regular basis.

SUPERVISORY RESPONSIBILITIES:

None