Critical Action Items:
- Monitor resident's insurance and Medicaid eligibility ongoing basis.
- Meet Face to Face with guardians to review Medicaid eligibility and insure applications submitted on time with no lapse in coverage
- Track Medicaid renewal dates and update case files including Therap
- Acquire private insurance annual denial letters and submit to Medicaid as identified for each resident affected
- Update Therap with all insurance information
- Meet with resident's guardians and complete and submit annual and as needed Medicaid eligibility documents to include:
- Medical Power of Attorney
- Hospital Selection
- Do Not Resuscitate Form
- Monitor and track guardianship papers and file electronically and hard copy in case file
- Update Emergency Contact Data regarding guardianship in electronic and hard copy and update QIDP, House Managers and Medical Staff
- Update case file both hard copy and electronic of all DNR and hospital preferences
- Meet with guardians to verify resident meets all eligibility for services at BVT
- Update QIDP, Biller, Program Director and Medical Staff of any and all changes in eligibility
- Update Trust Fund expenditures and requests by residents and guardians
- Maintain Trust Fund accuracy and provide information as requested and required to DADS Trust Fund auditor
- Update guardian when trust fund balance has less than one month of PNA funds available to resident.
- Monitor and track annual IDRC due dates and coordinate completion with QIDP with minimum of 2 weeks prior to expiration.
- Enter IDRC information into TMHP website as service authorization and monitor.
- Assist Program Director with review of Absences and entry into TMHP/CARE all movement
- Assist Program Director with completion of Living Options prior to expiration/past due status in CARE system
- Perform the various duties required of a QIDP (Qualified Intellectual Disabilities Professional) including developing, monitoring and revising active treatment goals and objectives; conducting annual Interdisciplinary Team Meetings (IDT) and interim IDT meetings for residents; writing quarterly, interim, and annual reports for residents as assigned.
- Observe and document resident behaviors on appropriate forms such as Behavior Progress Notes, Weekly Progress Notes, or other forms as necessary.
- Maintain awareness of resident rights restrictions, prepare documents for rights restrictions and participate in the Human Rights Committee as needed and maintain appropriate documentation.
- Maintain awareness of individuals without guardians who are unable to make an informed decision, completing and submitting documentation to a Surrogate Decision Making Committee as needed and appropriate.
- Assist each resident toward the achievement of active treatment goals, working both formally and informally to provide active treatment through all activities and interactions.
- Provide transportation for residents to appointments and activities or with shopping needs and personal errands as needed.
- Assist Program Director in filing and completing various monthly documents and documentation.
- Coordinate with parents and guardians and House Managers any Day Hab absences for each assigned resident and update and coordinate services with Day Hab and Program Director of all schedule
- Attend all meetings as assigned by Director of Residential Services
- Trust Fund balances monthly with accounting
- Annual Medical eligibility forms updated and reviewed including DNR, Hospital Preference and Medical Power of Attorney completed prior to 1 year
- Monthly report to Program Director on status of each case and pending action for next 30 days
- Meet with guardians to review annual eligibility requirements in timely manner.
- Document resident behaviors on appropriate forms.
- Perform other job duties as assigned by Director of ICF-IID Services.
- Attend Psychological appointments if RN is unable to attend.
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Bachelor's Degree in Human Service Field.
Experience working with individuals with intellectual and developmental disabilities or some other form of direct care. Prefer individual certified as a QIDP and experience with completing, submitting, and monitoring Medicaid applications. Must be competent and proficient working with Microsoft Word, Excel and Outlook.
- Possess a valid driver's license, work eligibility status and have a good driving record.
- Must pass all background checks including: Criminal, Employee Misconduct, Nurse's Aide Registry, Driving check.
- Able to organize and prioritize a wide variety of tasks
- Able to work in a team environment with flexibility.
- Know the indicators of abuse, neglect, and exploitation and the appropriate documentation and reporting procedures.
- Able to complete Medicaid application and meet effectively and supportively with guardians.
- Know procedures for administering, charting, and storing resident medications.
- Communicate promptly with Director of ICF-IID, QIDP, and /or biller regarding needs and problems of individual ICF-IID residents.