Community Care Worker III (CT) Job Listing at Texas Health and Human Services in HARLINGEN, TX (Job ID 612209)

Description

Community Care Worker III (CT)

Serves as a specialist in the Program Support Unit (PSU) performing moderately complex tasks related to managed care Long Term Services and Supports (LTSS). Work involves frequent contact with case managers in Community Care Services Eligibility (CCSE), individuals enrolled in or applying for 1915(c) waiver services, service providers, LTSS MCOs, relocation specialists, nursing facility staff, the public, Health and Human Services Commission, Managed Care Compliance and Operations, Health Plan Management, and Medicaid for the Elderly and People with Disabilities (MEPD) staff. Works under general supervision with moderate latitude for the use of initiative and independent judgment. Work includes operating a computer and requires an extensive knowledge of CCSE/PSU programs and software.

Duties include case management activity, for example helping people select a managed care organization (MCO), approving and denying eligibility for a Medicaid 1115 waiver program, playing a key role in transitioning individuals from nursing facilities to the community (Promoting Independence), entering or validating waiver eligibility records in authorization systems, notifying members of Medicaid 1115 Waiver program eligibility, managing fair hearing request for Medicaid 1115 Waiver program denials, transfer of Medicaid 1115 waiver program cases, and coordinating the aging out process for individuals enrolled in the Medically Dependent Children Program (MDCP).