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Case Manager Job Description

 

Objective:

The objective of case management is for support, service counseling,and assist participants with changing needs and making decisions regarding long-term care. It also ensures continued access to available and appropriate services.

 

Qualifications:

  1. Case Management services will be conducted by one of the following:

    1. Social Worker licensed by the state of SC

    2. Individuals with a Bachelor's degree in health or human services field from an accredited college or university, who have at least 2 years of assessment and care planning experience with clients (experience cannot include more than 6 months of internship).

    3. Registered Nurse Licensed by the State of SC or by a state that participates in the nursing compact.

    4. Professional Counselors currently licensed by the state of SC.

    5. Certified Geriatric Care Managers with 2 years of assessment and care planning with clients.

    6. Certified Case Managers with 2 years of assessment and care planning with clients.

  2. Non-licensed professional Case Managers MUST have:

    1. A minimum of 10 hours relevant in-service training per calendar year.

    2. Must not have a felony conviction of any kind.

    3. Must have demonstrated skills in computer hardware/software access and usage.

    4. Must have a PPD tuberculin Skin Test no more than 90 days prior to employment.

    5. Must not be a provider of services which could be incorporated into Community Long Term Care waiver services, home health services, and nursing facility services.

    6. Must not be employed by, consulting to, or contracted with any company providing services which could be included in a plan of care.

Responsibilities:

  1. Case Management services must be provided in accordance with Community Long Term Care Service Provider manual, the Community Long Term Care program policies and procedures, the applicable SC Department of Human and Health Services polices and procedures, and the applicable federal and state statues and regulations. All the foregoing provisions, polices, procedures statues and regulations (together with any subsequent amendments) are hereby incorporated as an integral part of the responsibilities.

  2. Case Managers must co-locate in Department of Health and Human Services regional office facilities.

  3. Case Managers cannot carry a caseload over 80 without the approval of the Community Long Term Care Area Administrator and Chelle's Creations Case Management Services, LLC

  4. Case Managers are required to attend the first Division of Community Long Term Care Case Managers Orientation Program AFTER becoming employed provide services under the contract of Chelle's Creations Case Management Services, LLC and shall attend on-going Medicaid sponsored Case Management training, and SC Department of Health and Human Services/Community Long Term Care in-service programs.

  5. Case Managers are required to attend any other training required by Community Long Term Care staff.

  6. Case Managers must participate in the Care Call monitoring system, Care Call documentation is required at the time of the work. Written documentation for home visits is to be completed while in the participant's home.

  7. Case Managers agree to use Community Long Term Care automated Case Management System to document case management activities and produce ALL necessary reports in a timely manner.

Description Of Services To Be Provided:

  1. Ongoing evaluating the service plan, ongoing monitoring, and developing.

  2. Authorizations for waiver services, including; initial, changed, or terminated authorization of services.

  3. Resource assessment and develop referrals to outside or other agencies as needed.

  4. Service coordination to include coordination of community based support and participation in inter-agency case staffing.

  5. Monthly case monitoring or more as appropriate. F. Case revaluation every 3 months G. Level of care review and determination. H. Service counseling with participant and family.

  1. Case termination and transfer.

  2. The unit of service will be one calendar month, or any portion thereof, commencing on the date that the participant is entered into case management. The unit will include ALL necessary case management activities performed that month.