Dedicated & experienced Senior Support Broker/Case Manger with over 20 years of experience in case management specializing in the WV State Medicaid Waiver programs. Proven track record of providing comprehensive support to participants, maintaining high caseloads, and ensuring compliance with Medicaid regulations. Skilled in completing assessments, service planning, and monitoring health and safety. Adept at mentoring and training new staff, with a strong commitment to empowering individuals to maintain independence and quality of life.
· Responsible for providing information, advocacy, resources and supports to participants in the Personal Options program, the self-directed module for the WV Medicaid Aged and Disabled Waiver Program, the Intellectual/Developmental Disabilities Waiver & the Traumatic Brain Injury Waiver Program.
· Conduct assessments to address physical, mental & emotional needs and develop service/care plan based on individual needs.
· Responsible for six-month monitoring visits with program members as well as monthly phone contacts to monitor health and safety. Assist program members with maintaining eligibility for the Waiver Programs & with their medical re-evaluation paperwork.
· Maintain a high caseload in all 3 state Waiver Programs. Return phone calls & emails within 24 business hours.
· Apply outstanding communication & interpersonal skills to present information to program members of all levels of education on their role as an employer in a self-directed program. Ensure all members and their employees understand the information and resources provided by PPL, including their own responsibilities.
· Assists program members with program enrollment forms, tax forms, employee paperwork, and Legal Representative paperwork.
· Creates spending plan for Medicaid Waiver budgets & assist with payroll issues.
· File management responsibilities include maintaining participant records in accordance with Medicaid regulations in company web portal system , CRM, Care Connections, WV Incident Management System, and in a remote office.
· Assist Program Manager with case file organization and pre-audit before each annual state audit, for the Aged & Disabled & Traumatic Brain Injury Programs. Also attend these yearly audits to assist Program Manager & Supervisors.
· Mentor & assist with training new staff
· Created and presented training for all staff on Aged & Disabled Waiver Assessments and Service Plans.
· Proficient in computer application skills and navigation including Microsoft Word, Outlook, Excel, & Teams.
Provided case management for home & community-based services to families. Developed & monitored individual service care plans based on client needs. Conducted monthly home visits to monitor health & safety. Provided crisis assistance & support. Developed & conducted weekly educational groups at the local YWCA Readiness Center & Sojourners Homeless Shelter. Completed documentation and monthly Medicaid billing and rebilling. Provided counseling to center patients