Minimum Qualifications
Possess an active Pennsylvania nursing license. Possess Case Management Society of America recognized certification as a Care/Case Manager, including the Commission for Case Manger Certification, National Academy of Certified Care Mangers, or American Nurses Credentialing Center; or Currently working towards this certification with documented experience with the intent of receiving certification through examination at the next possible date, currently June of 2005. Continued service would be conditional on candidate obtaining certification at said time. Possess a documented work history of two (2) or more years of experience in care management.
Possess basic Computer Skills to include, but not limited to, Microsoft Office Products
Role Description:
Resource will provide managerial leadership and oversight to project and processes. Resource will be assigned to workgroups and project teams. Assignments will consist of a combination of on-going process responsibilities, standing work group participation and time-limited projects related to the management and operations of all aspects of the Pennsylvania Medicaid program, including but not limited to:
Develop policy and procedure to support a special needs/case management unit based on the Case Management Society of America guidelines; Train staff on the principles of case management and the availability of community and state resources;
Develop a listing of community and state resources for use by the case/care manager;
Collaborate with other bureaus/contractors which address special needs to assure continuity of services;
Maintain oversight of the case management process and assist in developing staff to qualify for case/care manager certification;
Collaborate with the Enhanced Primary Care Case Management and disease management vendor as necessary;
Evaluation of currents processes and implementation of recommended process improvements;
Consult with senior staff to outline major operational issues and develop resolutions based on sound data analysis;
Act as liaison between the Department of Public Welfare and external stakeholders (individuals and/or groups);
Assist in determining if any changes should be made to criteria or
regulations to better serve their clients; and Interface with Providers.
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