Since 1968, the Top of Alabama Regional Council of Governments (TARCOG) has united municipal, county, and state governments and federal agencies to work as a single team focused solely on improving the region that now includes more than 713,000 residents.
We identify and address common regional issues, opportunities, and challenges of northeast Alabama’s municipalities and counties, including DeKalb, Jackson, Limestone, Madison, and Marshall.
TARCOG is seeking a dynamic Nurse Case Manager to join our team. We are looking for an individual who shares our core values of service, initiative, accountability, and transparent communication.
SUMMARY DESCRIPTION: Responsible for implementation of the Technology Assisted (TA) Waiver for Adults under the Medicaid Waiver Home and Community-based Services Program within the TARCOG area and surrounding counties following specific requirements as set out in Medicaid Waiver guidelines. Duties include, but are not limited to, assessments of new clients, yearly redeterminations of current clients, home visits to monitor services provided by contractors and determine additional needs of client, verification of monthly billing submitted by contractors, and completion of daily service logs.
SUPERVISORY CONTROLS: Receives general instructions from the Medicaid Waiver Program Manager. Supervisor sets limitations, quality and quantity expected, deadlines and priorities; employee uses initiative in carrying out assignments; and work is checked for technical accuracy.
RESPONSIBILITIES AND DUTIES:
- Establishes referral sources by disseminating information to organizations, agencies, and individuals. Responds to written referrals from ADSS for TA Waiver; receives and responds to written referrals from LTC facilities for ACT Waiver; receives and responds to verbal and written referrals of eligible Medicaid recipients in order to obtain information on potential Medicaid clients and to provide information to referral sources for E&D Waiver.
- Assesses and manages ventilator dependent and/or homebound clients who are eligible and active on the TA Waiver Program and other Waiver Programs.
- Works with DME providers, physician’s offices and family members to procure necessary medical equipment for clients on the TA Waiver; facilitates needed repairs on said equipment and devices; and is involved in the acquisition of medications approved through the TA Waiver.
- Authorizes contractors to initiate services after receiving notification of approval from Alabama Medicaid Agency, and forwards appropriate copies of assessments, care plans, and service authorization forms to the respective contractors. Visits contractors’ offices and exchanges information with appropriate personnel to ensure that the contractors are operating as outlined in guidelines.
- Develops, monitors, and revises client’s care plan in coordination with client/caregiver to fit the needs of the client. Conducts monthly visits to clients’ homes and evaluates the services being provided by the Waiver Programs to ensure the services are appropriate, adequate, and of acceptable quality. Prepares case notes of visits and evaluations for documentation to be placed in case files.
- Checks monthly billings submitted by contractors for services rendered to clients in order to determine that the billing is accurate and the claims are in conformity with the clients’ Care Plans. Monitors the cost effectiveness of Waiver services for each client.
- Conducts yearly redetermination assessments on clients as outlined in the Waiver guidelines and completes appropriate forms in order to meet requirements prescribed by the Alabama Medicaid Agency.
- Places all documents as prescribed by TARCOG and the Alabama Medicaid Agency in appropriate folders in order to maintain a permanent case record for each approved client.
- Composes and maintains the following reports as necessary: HCBS Program Case Management Activity Record, Case Managers Daily Time Logs, and Respite Hours Logs.
- Exchanges information with Medicaid Wavier clerical staff through written and verbal communication in order to assign work and follow up on tasks.
- Provides training to staff members on Health Literacy and completion on the Expanded Assessment.
The assignment of duties is not limited by the content of the job description.
KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED:
- Knowledge of social work programs and processes.
- Knowledge of community resources and support network available to clientele served.
- Knowledge of Health Insurance Portability and Accountability Act (HIPAA).
- Knowledge of Insurance, including Medicaid State Plan, Medicare, Private Insurance, and waiver programs.
- Ability to communicate orally and in writing to exchange information with co-workers, clients, service agencies, state agency personnel, etc.
- Ability to relate to the elderly and their unique problems.
- Knowledge and ability to write and print legibly.
- Knowledge and ability to operate office equipment including telephone, copy machine, fax machine, computer, and calculator.
- Knowledge and ability to do basic arithmetic.
- Ability to read and interpret guidelines and regulations and apply them to the job.
- Completion of initial case manager’s training within three (3) months of employment.
- Bachelor’s 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.
- At least two (2) years work experience as a RN.
- A valid driver’s license and a good driving record.
TARCOG is an Equal Opportunity Employer.
Job Types: Full-time, Part-time
Pay: $22.00 - $30.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
Work Location: In person