Minimum Qualifications:

• Bachelor of Social Work from an Accredited Social Work Program or equivalent education and experience.
• Basic computer skills to include, but not limited to, Microsoft Office Products.

JOB DESCRIPTION, DUTIES AND RESPONSIBILITIES:

The incumbent will be assigned to the Division of Participant Supports, Critical Incident Management Unit and will be tasked (1) to provide to local agencies effective assistance related to reportable incident management for participants, specifically as they concern home and community-based waiver and other community based programs; (2) to assist in ensuring effective follow-up and technical assistance for all Protective Service cases identified within OLTL waiver programs; (3) to assist with health, safety and welfare assurances reports mandated by CMS guidelines.

• Review electronically submitted incident reports to ensure that service coordinators are effectively supporting the health and welfare of participants receiving home and community based services offered by the Office of Long-Term Living (OLTL). As necessary, seek additional information and provide technical support to assist Service Coordinators and Managed Care Organizations (MCO) to complete investigations and establish corrective actions. Follow-up with Service Coordinators and MCOs to ensure that all components of an incident are investigated and acted upon in a timely manner and that the health, safety, and welfare of the participants are ensured.
• Provide technical assistance and support for any Protective Services Report of Need received for a participant in one of the OLTL waivers or Act 150 programs. Provide case management assistance to Service Coordinators and MCOs to secure appropriate services for participants at risk. Provide guidance in developing an effective plan to identify and address short and long term risks to participants.
• Participate in the review of service plans for participants with complex needs, providing technical support and guidance to Service Coordinators, participants, caregivers and service providers as necessary.
• Respond orally and in writing to basic inquiries within a reasonable timeframe regarding home and community-based programs. Prepare responses to legislative inquiries for review by supervisor. Investigate complaints received from participant, service coordinator or supervisor and provide resolution, seeking supervision when necessary.
• Use established precedent and policy to provide guidance, consultation, technical assistance, to enrollment brokers, service coordinators applicants and caregivers; advise supervisor of problems and/or unusual issues as appropriate.
• Identify any operational issues which impede the provision of appropriate, cost-efficient services to individuals and recommend remedies/necessary changes to supervisor. As a member of a Team or Division group, participate in developing/revising OLTL home and community-based program policies and procedures.
• Prepare detailed analysis and summary of current issues, service plan and critical incidents trends, or other statistical data both to support projects as well as on-going management of the program.
• Participate in developing and presenting training to Division staff, other OLTL staff, key constituents and providers.
• Serve on workgroups comprised of staff from within OLTL or stakeholders from outside OLTL. Committee work may include: preparing Medicaid waiver amendments and renewals; evaluating policy recommendations, directives and regulations; and assisting with the development of operational manuals, program directives, work plans, system changes, regulations, training and policies and procedures to ensure that home and community-based waiver and community programs are administered accurately, effectively and efficiently and that services meet participant needs.
• Draft responses to programmatic reviews of service provider agencies conducted by staff from other bureaus, or reviews by federal oversight agencies such as Centers for Medicare and Medicaid Services (CMS). Work may include the development of written work plans to remediate particular findings in such reviews.
• As needed, accompany team member(s) on field travel to provide on-site technical support, re-mediation, and problem-solving to participants, families, providers and other key stakeholders.
• Attend and participate in team meetings, division and bureau meetings as scheduled.
• Participate in hearings as requested by the DPW Hearings and Appeals Office.
• Perform other related duties as required.

Essential Functions

• Understand OLTL Medicaid Waivers and Act 150 program, regulations, policies and procedures.
• Be knowledgeable of physical disabilities, associated limitations to Activities of Daily Living (ADLs), Instrumental ADLs, and relevant supports.
• Be technology-savvy and able to work remotely using videoconference and telephonic platforms. OLTL is currently on teleworking status.
• Ability to work remotely and independently, self-initiator.
• Organize and deliver presentations.
• Ability to prioritize tasks.
• Ability to explain programmatic requirements to participants, providers and other stakeholders.
• Ability to effectively communicate both orally and in writing.
• Understand and interpret local, federal and state laws as relevant.
• Working knowledge of Microsoft Office, HCSIS, SAMS, and CIS.

About Us:

TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.

TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com