Responsibilities
- Assumes responsibility for a designated client case load;
- Travels statewide to assess and evaluate potential clients eligible who are residing in nursing homes and who are candidates for transitions back to the community;
- Completes all MFP/DSS paperwork as required;
- Works as part of a team providing clinical expertise and knowledge to the other clients of the team;
- Conducts all recovery plan reviews, service authorizations and care coordination (or oversight and supervision) for all assigned clients;
- Maintains an understanding of behavioral health benefits and remains current on covered benefits, limitations, exclusions, and policies and procedures, in regards to services;
- Supervises collection of information regarding the delivery and outcomes of services to clients, and uses that information to recommend modifications to plan policies and procedures which improve the delivery of services to clients;
- Provides clients, providers, and other stakeholders with accurate and timely information concerning waiver benefits and coverage;
- Works with clients and providers to customize services to best meet client’s needs within the scope of the program;
- Works to assure that systematic revisions to improve services are developed and implemented;
- Coordinates, reviews and maintains daily logs for reporting purposes and for weekly preparation and analysis of trending reports;
- Assists with coordinating information and making presentations to participating providers, state and federal agencies, community groups and other interested parties;
- Facilitates linkages for clients and families between primary care, behavioral health providers and other social service or provider agencies as needed to develop and coordinate service plans;
- Collaborates with providers and others in order to conduct diagnostic screenings for substance abuse, mental health, co-occurring disorders and triage the referrals to appropriate waiver and/or treatment services, initial assessment, treatment planning and aftercare planning for clients;
- Assists assigned clients with smooth transitions when moving into or out of the community;
- Monitors and evaluates the effectiveness and outcome of treatment and service plans, and recommends modifications as necessary to provide optimal clinically appropriate services with a goal of maintenance in the community at the least restrictive level of care;
- Attends case conferences, interagency and provider treatment planning meetings for assigned clients;
- Utilizes supervision with Lead Intensive Care Manager regularly;
- Lends clinical expertise to WISE program staff;
- Participates in professional development activities;
- Attends annual Conflict of Interest training;
- Attends training specific to job duties;
- Maintains confidentiality of all client protected health information and adheres to all HIPAA related policies and procedures;
- Demonstrates ethical behavior and cultural sensitivity in all activities involving individuals of diverse backgrounds;
- Performs other tasks/responsibilities as required to support the business operations.
