Job Summary:

The Community Based Waiver Service Coordinator, Duals Integrated Care is responsible for managing and coordinating services for individuals who require long-term care support and are eligible for community-based waiver programs, ensuring that members receive the necessary services and supports to live independently in their communities while also coordinating care across various healthcare and social service systems.

Essential Functions:

• Engage with member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member.
• Conduct comprehensive assessments to determine the needs of members eligible for community-based waiver services.
• Develop individualized service plans that outline the necessary supports and services, ensuring they align with the individual’s preferences and goals.
• Serve as the primary point of contact for members and their families, coordinating care across multiple providers and services, including healthcare, social services, and community resources.
• Facilitate access to necessary services such as home health care, personal care assistance, transportation, and other community-based supports.
• Regularly monitor the implementation of service plans to ensure that services are being delivered effectively and that individual needs are being met.
• Conduct follow-up assessments to evaluate the effectiveness of services and make adjustments to person-centered care plans as needed.
• Advocate for the rights and needs of members receiving waiver services, ensuring they have access to the full range of benefits and supports available to them.
• Empower members and their families/caregivers to make informed decisions about their care and support options.
• Build and maintain relationships with healthcare providers, community organizations, and other stakeholders to facilitate integrated care.
• Lead and collaborate with interdisciplinary care team (ICT) to discuss individual cases, coordinate care strategies, and create holistic care plans that address medical and non-medical needs.
• Provide education and resources to members and their families/caregivers about available services, benefits, and community resources.
• Offer guidance on navigating the healthcare system and accessing necessary supports.
• Maintain accurate and up-to-date records of member interactions, care/service plans, and progress notes.
• Assist in preparation of reports and documentation required for compliance with state and federal regulatory requirements.
• Respond to crises or emergencies involving members receiving waiver services, coordinating immediate interventions and support as needed.
• Evaluate member satisfaction through open communication and monitoring of concerns or issues.
• Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program.
• Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law.
• Regularly verify and collaborate with Job and Family Service to establish and/or maintain Medicaid eligibility.
• On-call responsibilities as assigned.
• Perform any other job duties as requested.

Education and Experience:

• Nursing degree from an accredited nursing program or Bachelor’s degree in health care field or equivalent years of relevant work experience is required.
• Minimum of 1 year paid clinical experience in home and community-based services is required.
• Medicaid and/or Medicare managed care experience is preferred

Competencies, Knowledge and Skills:

• Intermediate proficiency level with Microsoft Office, including Outlook, Word, and Excel
• Prior experience in care coordination, case management, or working with dual-eligible populations is highly beneficial.
• Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries.
• Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers.
• Awareness of and sensitivity to the diverse backgrounds and needs of the populations served.
• Ability to manage multiple cases and priorities while maintaining attention to detail.
• Adhere to code of ethics that aligns with professional practice, including maintaining confidentiality.
• Decision making and problem-solving skills.
• Knowledge of local resources for older adults and persons with disabilities.

Licensure and Certification:

• Current and unrestricted license as a Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent Social Worker (LISW) in the State assigned is required.
• Case Management Certification is highly preferred.
• Must have valid driver’s license, vehicle and verifiable insurance.   Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance.  If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. 
• Employment in this position is conditional pending successful clearance of a criminal background check.  Results of the criminal background check may necessitate an offer of employment being withdrawn or, if employee has started in position, termination of employment.
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

Working Conditions:

• This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential.  Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
• Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need.
• May be required to travel greater than 50% of time to perform work duties.
• Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer.
• Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members.

Compensation Range:
$61,500.00 - $98,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Salary

Competencies:
- Create an Inclusive Environment - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

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