HCBS, UM & Waiver Program Team Manager

Under the direction of the Director of I/DD Services, supervises and manages the implementation of the Habilitation Supports Waiver Program, iSPA, Waiver Program,  Home and Community Based Services (HCBS), and clinical review of services requested for adults with intellectual and developmental disabilities.  Provides clinical supervision to staff as needed. Provides consultation, guidance, training, and oversight related to HCBS. May deliver direct mental health services to consumers and families as needed.

This is a full-time, benefited position working Monday - Friday, 8:00 am to 5:00 pm at the Community Mental Health location at 12265 James St., Holland MI 49424.The essential functions of this position include, but are not limited to, any combination of the following:

1. Oversees, coordinates, and monitors the Habilitation Supports Waiver (HSW) program.  Reviews, approves, and processes application packets.   Annual recertification and ongoing review of program participants.  Makes recommendations for new referrals and/or discontinuation of HSW services based on eligibility requirements. 
2. Provides training and oversight to staff on plan, goal and objective development for HSW and HCBS services ensuring that goals meet HSW requirements and individual plans of service do not contain restrictions without appropriate behavioral supports in place.  Coordinates with psychologists to develop plans that meet HCBS documentation requirements.
3. Provide training for providers and staff and review of documentation relating to the individual plan of service verifying compliance with Medicaid and the Home and Community Based Rule.
4. Supervision of the implementation of the iSPA Waiver program for the entire organization. Review, approval, and processing of initial enrollment and annual recertifications using the MDHHS Waiver Support Application (WSA) system. Training and communication to OCCMH teams on implementation and updates. Assist with problem solving throughout the organization when there are rejections from the WSA system.
5. Thorough review of Private Duty Nursing services for HSW participants.  Initiates and coordinates alternate programs when necessary.   Coordination with MDHHS, the PIHP, and other local and state programs when necessary.  Recommends MIChoice and PACE as appropriate.
6. Thorough review of all environmental modifications, durable medical equipment, and enhanced pharmacy requests.  Determines financial efficacy.  Assurance of medical necessity, exhaustion of community and natural supports, insurance denials and paperwork completion. 
7. Supervision of the implementation of Home and Community Based Services (HCBS) rules.   Coordination, training, and communication with MDHHS, the PIHP, providers and staff regarding corrective action plans, home visits, compliance issues, and plan writing, agency wide. 
8. Participation in regularly scheduled HSW, iSPA, and HCBS workgroup meetings with the PIHP and other regional coordinators. Participation in quarterly state meetings.
9. Maintenance of and CMHOC Lead for HSW, HCBS, and i(SPA) services through the Waiver Support Application (WSA) system. 
10. Participation in scheduled HSW, iSPA and HCBS audits by verifying all required documentation is in place.
11. Assures that services to consumers meet medically necessary eligibility standards in quality and quantity.  Quality standards include ensuring consumers are treated in a manner consistent with agency policy, divisional standards, and good clinical practice.  Quantity standards require demonstrating units of service provided reflect adherence to goals and have been recommended through various assessments.
12. Review and determination of medical necessity for service requests that meet or exceed assessed need.  Communication of approval or denial of requested service to staff with rationale. 
13. Establishes/plans/implements program priorities, goals, and outcomes in cooperation with the Program Director and other agency supervisors.
14. Performs other functions as assigned.

Master’s degree in psychology, social work, counseling, or related mental health field, is preferred; and at least two years of experience. Bachelor’s degree in psychology, social work, or related mental health field is required.   Relevant clinical internship is desirable and may be substituted for some of the required experience.
Lived experiences with mental illness, developmental disabilities, or substance use disorders are valued.

Licenses and Certifications:
Must possess State of Michigan licensure or certification (LMSW, LLP).
Must be a Qualified Intellectual Disability Professional (QIDP) as defined by the Medicaid rules. 
Possession of a valid Michigan driver’s license is required.Required Knowledge and Skills:

1. Thorough working knowledge of the principles and practices of social work, psychology, and the treatment of individuals with mental health, developmental disabilities and/or co-occurring mental health and substance use disorders.
2. Thorough knowledge of the principles of community integration and maximized independence. Good working knowledge of the principles and practices of community-based mental health services.
3. Thorough working knowledge of effective leadership techniques, independent problem solving, conflict resolution, teambuilding, and interagency collaboration.
4. Thorough working knowledge of MDHHS accreditation requirements and mental health care practitioner licensing requirements.
5. Good working knowledge of managerial and supervisory principles and practices.
6. Good working knowledge of relevant Evidence-Based Practices, relevant to specific target populations.
7. Ability to write clear and concise evaluation reports, progress notes, and other necessary documentation.
8. Thorough working knowledge of the principles and practices of medical record documentation and medical records management.
9. Good working knowledge of program assessment and quality assurance principles, practices, protocols and instruments.
10. Excellent interpersonal communication skills. Excellent verbal and written communication skills.
11. Computer literacy and working knowledge of word-processing, spreadsheet, database and project management software.

Working Conditions:
Works in office conditions and travels throughout the county to attend meetings, make presentations or provides services in homes. 

Disclaimer:
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.
 

Ottawa County is an Equal Opportunity Employer

Salary : $35 - $46