SCOPE OF POSITION :

The Habilitation Specialist is responsible for clinical coordination, monitoring, compliance, and administrative functions relevant to Medicaid Waiver In-Home Support & Hourly Respite services, and other authorized services and supports.

The Habilitation Specialist will require minimal supervision to fulfill duties including but not limited to person centered planning, developing functional assessments, participating in advocacy & outreach efforts, developing, and sharing resources to satiate unmet needs, maintaining compliance with Medicaid Waiver reporting requirements, and ensuring quality assurance.

The Habilitation Specialist is required to exercise administrative judgment and assume responsibility for decisions, consequences and results having an impact on the department and the quality of services delivered.

The Habilitation Specialist must possess the ability to effectively communicate, verbally and in writing, with internal and external stakeholders.

The Habilitation Specialist will routinely collaborate with various community agents, persons receiving services, and their families, when applicable.

The Habilitation Specialist will be assigned to work with a Community Support Monitor and will be required to demonstrate effective problem-solving skills and proactive teamworking.

This job does require the employee to use their own transportation resources, work a flexible schedule, and work remotely or telework, as needed.

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITES :

1. Intake & Admission : The Habilitation Specialist must implement the person-centered planning process and will coordinate all activities relating to intake and admission, immediately upon receiving Prior-Authorization, for service provision.

Schedule Intake meeting(s) and send intake notifications to all participants, primary caregivers, DDS Service Coordinators, legal guardians and other paid or unpaid supports, at the request of the person receiving services.

2. Person Centered Planning : Participate in all Individual Support Plan (ISP) Conferences, 6-month review, emergency case conferences, and interdisciplinary team meetings.

Contribute to the development of the Plan of Care and other relevant approaches, strategies, and interventions designed to assist the person with developing independent living skills and proactive supports.

Coordinate resources to enable individuals to increase their level of self-determination and enhance their quality of life.

3. In-Home Support Plan : Develop the In-Home Support Plan, annually at minimum, ensuring submission to Program Manager in congruence with the scheduled pre-ISP calendar schedule, maintaining DDS policy of submitting the document to the assigned Service Coordinator 15 days before the scheduled ISP meeting, and following document distribution policies and procedures.

Make recommendations to update, change or revise the In-Home Support Plan at least quarterly based on monitoring and assessment.

Ensure service documentation correlates with the participant’s In-Home Support Service Plan and Individual Support Plan.

4. Quarterly Reporting : Conduct a quarterly review of the participant’s ISP and Plan of Care goals, objectives and activities, PCT & Discovery Tools, clinical consults and other service documentation and propose modifications to the ISP or Plan of Care as appropriate.

The results of these reviews must be submitted to the individual’s DDS Service Coordinator within 7 business days of the end of each quarter, and each subsequent quarter thereafter, prioritizing adherence to TCS’s internal policy of submission of 5 calendar days following the end of each quarter, beginning on the effective date of a person’s ISP.

5. Training : Provide Phase II training, at minimum of annually while completing additional training(s) as needed, to Direct Support Professionals on the participant’s service documentation, person centered planning and support protocols.

Partner with the Community Services Monitor to coordinate training for professional service providers, as indicated in the person’s professional services assessment / recommendations.

Ensure evidence of training, counseling and supports is provided to the appropriate authorities.

6. Advocacy & Outreach : Recommend strategies and interventions that may improve services to an individual; including but not limited to the following : medical coordination, day support, in-home services, transportation, Individual Support Plan (ISP) amendments, and modifications in service hours, request for assessments and adaptive equipment requests.

Follow-up with interested parties at least monthly until the matter has been resolved or the strategies or interventions have been implemented.

7. Quality Assurance Clinical Review (QACR) : Participate in scheduled clinical review(s) of a sample of the Habilitation Specialist’s caseload.

The QACR process will review all authorized Medicaid Waiver services and other non-waiver or Medicaid State Plan supports for participants to include : In-Home Support, Professional Services, Nutrition Counseling, Behavior Support, Speech & Language Therapy, Family Care Training and any Specialty Clinics.

• o Show Coordination efforts made by Total Care Services, Inc. via quarterly reports, advocacy & Outreach, contact sheets and e-mail communication;
• o Review program records for continuity and clarity in accordance with Medicaid Waiver Records Protocol;
• o Indicate a plan of corrections for areas where deficiencies were noted;

o Assess service needs by evaluating assigned caseload.

8. Documentation : Develop and ensure distribution of accurate program documentation according to the Document Distribution Policies and Procedures;

including but not limited to : In-Home Support Plans, Quarterly Reports, PCT & Discovery Tools, and Weekly Progress Notes.

Review and approve progress notes, daily, confirming they fully and accurately detail the person supported’s goal progress.

Ensure all reporting mechanisms are kept confidential and adhere to HIPPA Regulations and follow Confidentiality Policies and Procedures.

9. Compliance : Ensure compliance with Total Care Services, Inc. and DDS policies and procedures policies and procedures.

10. Utilization Review & Audit : Participate in systematic examinations of clinical records, payroll records, training records, and other documents to ensure that the records are compliant with Medicaid Waiver Regulations and an accurate representation of services rendered.

11. Logistics : Organize and manage resources in order to meet requirements of persons receiving services and Total Care Services, Inc.

Execute and implement strategies recommended in the person’s In-Home Support Plan, Individual Support Plan and Plan of Care.

Requirements

QUALIFICATIONS :

Bachelor’s degree in social services, and 2 years of supervisory experience in Human Services;

Must be flexible to respond to :

• Must be a licensed driver;
• Must have own transportation available for business use;
• Minimum 21 years of age;
• Must be a U.S. citizen or alien who is lawfully authorized to work in the U.S.;
• Be free of active TB as confirmed by an annual PPD skin test and or Chest X-ray;
• Must be able to work a flex schedule, be on-call, weekends, evenings, and respond to crisis, as needed.

HABILITATION SPECIALIST AGREES TO :

• 2. Maintain contact with all paid and natural support team members (parents, day program, etc.) if additional information is required to effectively coordinate services and complete assessments;

3. Provide a weekly report(s), reflecting advocacy efforts, made to resolve identified, unmet needs, as relevant, for each respective member of the caseload.

• 4. Report serious reportable and reportable incidents in accordance with TCS incident management policy and protocol;
• 5. Act as liaison between government officials, persons receiving services, families, guardians, attorneys etc.;
• 6. Participate in any DDS required training and company recommended training;
• 7. Coordinate all activities, supports and resources relating a participant’s intake, admission, review and discharge;
• 8. Perform the duties of Community Services Monitor pursuant to the CSM job description when the Community Services Monitor is unavailable to perform duties (Attachment B, Community Services Monitor Essential Functions);
• 9. Adhere to Total Care Services, Inc. policy on transportation and the registration, insurance and upkeep of employee vehicles used for business purposes;

10. Perform the essential job functions of Habilitation Specialist and other relevant duties as assigned in accordance with this job.

Work Environment : This hybrid position is work from your field work and corporate office.

Provided with a laptop, printer, and cell phone

Total Care Services, Inc . is committed to equal employment opportunity and to compliance with federal, state, and local laws governing non-discrimination.

Total Care Services, Inc. is proud to be an Equal Opportunity / Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class.

ATTACHMENT B

Community Supports Monitor

The Community Supports Monitor is responsible for coordination of community supports, monitoring, compliance and administrative functions relevant to Medicaid Waiver In-Home Support & Hourly Respite services and other authorized services and supports.

The Community Supports Monitor will work, requiring minimal supervision to fulfill duties including but not limited to : implementing program goals, advocacy & outreach, staffing and recruitment, monitoring and supervision, training, billing and payroll, resource coordination, compliance with Medicaid Waiver reporting requirements, and quality assurance.

The Community Supports Monitor is required to exercise administrative judgment and assumes responsibility for decisions, consequences and results having an impact on the department and the quality of services delivered.

The Community Supports Monitor must possess the ability to effectively communicate verbally and in writing with internal and external business professionals and communicate with the persons receiving services.

This job does require the employee to use their own transportation resources, work a flexible schedule, work remotely or telework, and work independently requiring minimal supervision to fulfill the job duties listed below as well as other relevant job duties as assigned.

Benefits

• 401(k)
• Bereavement leave
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Free parking
• Health insurance
• Life insurance
• Loan forgiveness
• Mileage reimbursement
• Opportunities for advancement
• Paid holidays
• Paid orientation
• Paid sick time
• Paid time off
• Paid training
• Referral program
• Travel reimbursement
• Vision insurance

Last updated : 2024-05-14