Support Broker/Service Advisor/Case Manager

Consumer Directed Option (CDO)/Participant Directed Services (PDS) is an alternative to the traditional service delivery model under the Medicaid waivers. Support Brokerage/Service Advisor and Financial Management are required for all Medicaid consumers who choose to self-direct their Medicaid waiver services.

GENERAL DUTIES AND RESPONSIBILITIES:

The support broker/service advisor provides all case management activities for individuals receiving CDO/PDS and blended services (self-directing some services and receiving others from traditional providers). The scope of work for the Support Broker/Service Advisor/Case Manager includes:

1. Assisting DMS with outreach to and enrollment of participants into waiver.
2. Assisting with training of participants and their contracted employees on the principles of self-determination.
3. Assisting the participant with development (and revision) of their service plan utilizing the person centered planning process and guiding principles.
4. Maintaining all records and documentation relative to each participant.
5. Assisting the participant with development of the emergency back-up plan, which may include arranging for the provision of emergency services if necessary.
6. Assisting the participant with purchasing goods/consumable medical supplies based on their approved service plan.
7. Requesting authorization of additional services and funding if needed.
8. Assisting the participant in locating service providers.
9. Processing contractor enrollment forms and forwarding to the Financial Management Agency and to DMS for approval.
10. Facilitating all required background checks of CDO/PDS employees.
11. Assisting the participant in hiring, training, scheduling and terminating service providers.
12. Assisting the participant with coordination of CDO/PDS, traditional waiver services, state plan services and community resources.
13. Providing technical assistance to the participant with managing their service plan.
14. Monitoring the participant’s compliance with the provision of services to ensure that service provision is within the scope of their service plan and prior authorization limits.
15. Forwarding information to the Financial Management Agency for the processing of payroll.
16. Coordinating with traditional waiver providers to ensure they participate in any person centered planning team meetings.
17. Assuring health, safety and welfare of participant and compliance with program guidelines.
18. Initiating a corrective action plan when it is determined that the participant is not compliant with program guidelines or presents a safety risk.
19. Recommending termination of participant from CDO/PDS when attempts to correct fail or when there is imminent danger to the participant’s health or safety.
20. Assisting the participant with transition to traditional services upon request of the participant or upon involuntary termination of CDO/PDS.
21. Complete program required face to face visits according to regulations.
22. Monitoring satisfaction with and quality of services provided.

SKILLS, KNOWLEDGE AND ABILITIES:

1. Ability to effectively coordinate and communicate with clients, service providers and the general public and other staff members.
2. Skill in establishing and sustaining interpersonal relationships.
3. Knowledge o human behavior.
4. Knowledge of community organizations and service system development.
5. Problem solving skills and techniques.
6. Knowledge and skill in social and health service intervention techniques and methodology.

EDUCATIONAL REQUIREMENTS NEEDED TO PERFORM THE DUTIES OF THE JOB:

1. Bachelor’s degree in a health or human services field from an accredited college or university; and at least one (1) year of experience in a health or human services field; or
2. Educational or experiential equivalent in the field of aging or disabilities; or
3. Registered nurse who has at least two (2) years of experience as a professional nurse in the field of aging or disabilities; or
4. Master’s degree in a health or human services field from an accredited college or university.
5. Current Kentucky drivers license