IDD Care Manager

Company: Vaya Health
Location: Lenoir
Posted on: November 22, 2021

Job Description:

LOCATION: Caldwell County, NC and McDowell County, NC / RemoteSALARY: Depending on qualifications & experience of candidate. This position is non-exempt and is eligible for overtime compensation.GENERAL STATEMENT OF JOB:This Intellectual and Developmental Disabilities (I/DD) Care Manager is responsible for providing comprehensive care coordination and monitoring (treatment planning case management) to individuals having a primary Intellectual Developmental Disability, which may include a secondary Mental Health or Substance Abuse need. This position requires a dynamic, proactive approach to assessment, monitoring and coordination of care, to ensure quality supports and consistent adherence to waiver requirements. This is a mobile position with work done in a variety of locations. The I/DD Care Manager spends a considerable amount of time in the field and completes required documentation/paperwork.Note: This position requires access to and use of confidential healthcare information or protected health information (PHI) as described in laws addressing patient confidentiality, including, but not limited to, the federal HIPAA law, the Confidentiality of Alcohol and Substance Abuse Patient Records law, 42 CFR Part 2, and various state laws. As such, the individual filling this position shall be required to be trained regarding such laws and shall be required to observe those laws in his/her capacity as an employee of Vaya Health. The individual filling this position shall also sign a confidentiality statement as an employee of Vaya Health.ESSENTIAL JOB FUNCTIONS:Assessment and Planning:

• Utilizes person centered planning methods/strategies to gather information and to get to know the individuals supported.
• Provides education and support to individuals in learning about and exercising rights.
• Consistently completes Discovery activities (information gathering and assessment) in advance of planning meetings.
• Ensures that individuals/legally responsible persons are informed of services available, service options available, (e.g. Individual/Family Direction for Innovations participants), processes (e.g. requirements for specific service), etc.
• Provide information to individuals/legally responsible persons regarding their choice in choosing service providers, ensuring objectivity in the process.
• Assists the individual supported to direct the planning process/plan development, to the extent desired by the individual.
• Facilitates and coordinates timely development of the Individual Support Plan, crisis plan and Behavior Support Plan (as applicable).
• Participates as needed and necessary in crisis intervention and planning. May include nights and weekend phone calls as well as collaboration with Mobile Crisis teams as needed.
• Actively collaborates with individuals supported and members of the treatment team to ensure development of an Individual Service Plan that is comprehensive and reflects the individual's needs and desired life goals.
• Promotes use of natural/community resources through the assessment/planning process.
• Ensures that assessments/plans are updated, as needed, whenever the individual's life circumstances change.Support Monitoring/Coordination:
  • Monitors to ensure quality care, health/safety of the individual, as well as the continued appropriateness of services.
  • Ensures that services are monitored (including direct observation of service delivery) in all settings.
  • Makes announced/unannounced monitoring visits, including nights/weekends as applicable.
  • Monitors services for compliance with state standards, waiver requirements, and Medicaid regulations, as applicable.
  • Promotes problem-solving and goal-oriented partnership with individuals/legally responsible persons, providers, etc. recognizes and reports critical incidents.
  • Promotes satisfaction through ongoing communication and timely follow-up on any concerns/issues.Documentation and Fiscal Accountability:
    • Educates individuals/families on methodology for budget development, total dollar value of the budget and mechanisms available to modify the individual budget.
    • Verifies that services are delivered as outlined in the Individual Support Plan and addresses any deviations in service. Ensures that service orders/doctor's orders are obtained, as applicable.
    • Work with Eligibility and Enrollment Department to ensure verification of an individual's continuing eligibility for Medicaid
    • Proactively responds to an individual's planned movement outside the Vaya geographic area to ensure changes in their Medicaid County of eligibility are addressed prior to any loss of service.
    • Coordinates Medicaid deductibles, as applicable, with the individual/legally responsible person and provider(s).
    • Proactively monitors own documentation to ensure that issues/errors are resolved as quickly as possible.
    • Ensures accurate/timely submission of Service Authorization Requests (SARS) for all Vaya funded services/supports.
    • Ensures all clinical documentation (e.g. goals, plans, progress notes, etc.) meet state, agency and Medicaid requirements.
    • Maintains administrative record compliance/quality, as demonstrated by > 95% compliance on Qualitative Record Reviews/Chart Audits.Other duties as assigned.QUALIFICATIONS & EDUCATION REQUIREMENTS:A Bachelor's degree in Special Education, Psychology, Social Work or closely related Human Services area and 2 years of post-degree professional experience. Must qualify as a QP for Developmental Disabilities.PHYSICAL REQUIREMENTS:This position must have the ability to establish appropriate and respectful relationships/partnerships with organizational personnel. Ability to work with a multidisciplinary team approach. Ability to assume a helping role and to intervene appropriately to meet the needs of providers, consumers or families served. Works within the established ethical guidelines developed for the profession.KNOWLEDGE, SKILL & ABILITIES:A demonstrated knowledge of the assessment and treatment of developmental disabilities, with or without co-occurring mental illness, is a necessity. Employee will participate in and maintain Care Coordination and Vaya trainings as required.This position requires exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts and established processes. Problem solving, negotiation and conflict resolution skills are essential to balance the needs of both internal and external customers.The employee must be detail oriented, able to independently organize multiple tasks and priorities, and to effectively manage and assigned caseload under pressure of deadlines.Proficiency in Microsoft Office products (such as Word, Excel, Outlook, etc.) and Vaya information system is required.DEADLINE FOR APPLICATION: Open Until FilledAPPLY: Vaya Health accepts online applications in our Career Center, please visit http://www.vayahealth.com/careers-overview/ Ind.001Vaya Health is an equal opportunity employer.

Keywords: Vaya Health, Gastonia , IDD Care Manager, Executive , Lenoir, North Carolina