ALF Case Manager

Role Overview

• Check Medi-Cal eligibility for each client monthly.
• Schedule monthly visits with clients.
• Speak to clients and find out if anything is needed, such as, DMEs, appointments, etc.
• Ask about medication compliance and other general assessment questions.
• Speak to staff: Find out about any SIRs. IF so, make sure that our office has them. Find out if anyone is out and does not have an SIR. If this is the case, tell staff there they must get an SIR in ASAP. You must make sure to follow up with facility staff on this and make sure our office gets an SIR copy.
• If there are Medi-Cal issues then communicate this to client and facility staff and guide them how to resolve it (assuming they do not know how).
• Ask staff about medications and check the log.
• Make sure to update client information on company tracking system of visit dates and when note is uploaded in Devero. All notes must be uploaded by the end of the next business day from when you saw the client. Make sure you write in your note that you asked client and staff about med-compliance.
• As per workflow process, when a client is out of a facility, the CCA has specific tracking responsibilities. You as a ALF Case manager are to keep track of when clients leave as you visit the facility.
• Notify the ALF Coordinator when a client has left and returned to the facility.
• When a Re-Assessment is done, the RN will communicate to you via email that it is done and that you need to make a copy of ISP and have client sign it. And give a copy to the facility. Then upload to Devero and Email your CCA that it is done. You need to have the client sign it within 7 business days.
• Knowledge of Confidentiality, HIPAA and healthcare laws and regulations.
• Maintains proper timekeeping.
• Follows policies and procedures as per Employee Handbook.
• Maintains all credentials up to date.
• Reports Fraud and Abuse.
• Knowledge of mandated reporting.
• Conducts timely recording and/or documentation of client contact.
• Attends Department meetings (in person, by phone or by web).
• Attends all State mandated in service trainings.
• Driving may be required to geographical areas that are covered by the company. Significant amount of driving may be required throughout the Los Angeles, Fresno, San Diego, Riverside and San Bernardino County.
• Performs other duties as assigned.

Requirements

• Bachelors Degree in either social work, psychology, counseling, rehabilitation, gerontology, or sociology, plus one year of related work experience.
• Possesses current CPR certification.
• Knowledge of The State of California Assisted Living Waiver Care Coordination Agency preferred.
• Experience in the field of education or training, quality assurance and management preferred.
• Exercises excellent judgment and knowledge of current clinical practices, with demonstrated exemplary clinical, analytical, and documentation skills.
• Good organizational skills.
• Is self-directed with the ability to work with little supervision.
• Proficient in the use of computers, and electronic information systems.
• Ability to establish and maintain good communication and relationships with the office, field, and administrative personnel.
• Familiarity with Title 22 preferred.
• Must be a licensed driver with an automobile that is insured and is in good working order, in accordance with state and/or organizational requirements.