JOB SUMMARY: The Medicaid Service Coordinator arranges for and coordinates services and supports for developmentally disabled individuals receiving Medicaid waiver services.
ESSENTIAL DUTIES & RESPONSIBILITIES: The MSC Supervisor must be able to consistently and successfully perform all essential functions of the position.
1. Develop, implement, and maintain the individual's ISP
2. Maintain monthly contact with individuals on caseload.
3. Review the ISP and Habilitation Plans
4. Maintain the consumer's "primary record"
5. Ensure the completion of an annual re-determination of the need for the level of care in an ICF/MR (and any necessary re-determination of Medicaid eligibility)
6. Document service coordination activities in the Medicaid Service Coordinator's notes
7. Submit monthly billing
8. Facilitate and document a change in service coordination
9. Secure or continue to secure an advocate for each enrolled consumer who requires or chooses to have one, and document attempts
10. Maintain roster of individuals receiving services (MSC)
11. Notify DDSO of HCBS terminations
12. Notify family and/or consumer regarding termination of services
13. Ensure that the individual's fire safety needs are carried out as stated in the ISP
14. Ensure individual/individual family knowledge of 24 hour emergency contact number
15. Follow incident reporting procedures as determined in the agency's Incident Management Policy & Procedures
16. Train new service coordinators in all policies and procedures related to the role of the Medicaid Service Coordinator, to include “shadowing” by new service coordinator.
17. Assist Coordinator of Service Coordination with timesheet and billing paperwork, as needed
18. Assist in the coordination and assignment of Medicaid Service Coordination cases, including direct supervision of Medicaid Service Coordinators, to ensure adequate provision of services.
19. Provide on-call 24-hour phone coverage at least one week per month
20. Maintain a caseload of high priority service coordination cases
21. Perform any other duties as requested by your supervisor
EDUCATION and/or EXPERIENCE: Bachelor Degree or higher in a health or human service field AND one year experience as a service coordinator working with any population OR one year's practical experience working with people with disabilities. At least one year of supervisory experience is preferred. Meet the qualifications of a Qualified Mental Retardation Professional(QMRP): (1)At least one year of experience working directly with persons with mental retardation or other developmental disabilities; and (2) Is one of the following:
(i)A doctor of medicine or osteopathy
(ii)A registered nurse
(iii) An individual who holds at least a Bachelor’s Degree in a professional category.
1. (Please note that a candidate for a bachelor's degree in an unrelated field may meet this educational requirement by providing a letter from his or her college verifying that the candidate has completed course work equivalent to an Associate's degree both in the total number of credits received and number of credits earned in a health or human service field.)
2. An Associate Degree in a health or human service field or a license to practice as a registered nurse, three years of service coordination related experience with any population OR three years experience working with people with developmental disabilities. At least one year of supervisory experience is preferred.
CERTIFICATES, LICENSES, REGISTRATIONS Etc. - Participation in an OMRDD approved training curriculum in service coordination within three months of assuming MSC responsibilities, unless verification of past attendance at Core training is provided. A copy of Core certificate must be kept on file.
COMMUNICATION SKILLS - Fluent in oral and written conversational Spanish (bilingual only); ability to read, analyze, and interpret general education periodicals, professional journals, technical procedures, or government regulations; ability to write reports, correspondence; ability to effectively present information and respond to questions.
OTHER SKILLS & ABILITIES - Ability to define problems, collect data, establish facts, draw valid conclusions, solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret an extensive variety of instructions furnished in written, oral, diagram, or schedule form. Should have a comprehensive knowledge of community resources and a thorough understanding of the consumer's personal preferences and needs.