Case Manager (Fairfax/Loudoun)

Brain-Injury-Services-; Fairfax (VA); On-site; USD 52,000 - 72,000; Full time

Job summary

Brain Injury Services in Northern Virginia is seeking a full-time Brain Injury Case Manager to provide community-based case management to adults and children with acquired brain injury and their families in Fairfax County and Loudoun County.

Under the supervision of the Senior Manager of Case Management Services, you will perform intake, coordinate referrals, complete Medicaid TCM paperwork, and assess client needs and resources within 45 days of opening a case.

Qualifications

• Strong background in case management and at least 2 years of experience.
• Experience navigating Medicaid referrals and service authorizations.
• Ability to monitor billing and collaborate with MCOs in TCM services.
• Knowledge of confidentiality and documentation standards.

Responsibilities

• Adhere to professional standards, federal and local requirements, and MCO regulations.
• Obtain information and make referrals for appropriate services, including TCM-related referrals.
• Do a comprehensive intake evaluation, including documentation and medical records collection.
• Complete all Medicaid TCM paperwork, including service authorizations, assessments, billing and reporting.
• Complete a thorough client assessment covering strengths, needs, family and community support, within 45 days of opening.
• Obtain appropriate releases and uphold confidentiality laws.

Skills

Case management experience

Two years experience

Medicaid referrals

TCM knowledge

Job description

Description

Brain Injury Services (BIS) seeks a full-time Brain Injury Case Manager to serve our clients. We are seeking case managers with a strong background in case management and at least 2 years of experience. Preferences will be given to candidates who have experience navigating Medicaid referrals, submitting service authorizations, monitoring billing, and collaborating with Managed Care Organizations (MCOs) in the Targeted Case Management (TCM) services for BIS clients.

Position Service area:

Fairfax County and Loudoun County

Definition:

Under the supervision of the Senior Manager of Case Management Services, the Case Manager provides community-based case management to adults and children with acquired brain injury and their families in the Northern Virginia region. The adult brain injury program includes long-term case management services and public awareness. These services are provided using a community-based case management model.

Distinguishing Characteristics:

This position requires a professional level of intervention with complex cases. The Case Manager position assumes the ability to work independently and exercise autonomy. The Department Manager may designate other duties. This position is guided by the mission of this organization to support individuals with brain injuries and their families in reaching their maximal level of functioning within their communities using a person-centered approach.

Essential Job Functions and Responsibilities:

• Adhere to professional standards, federal and local requirements, and MCO regulations to serve and protect the agency.
• Obtain information and make referrals for appropriate services, including TCM-related referrals and general referrals to community services.
• Do a comprehensive intake evaluation, including completing all documentation designated in the Policy and Procedure Manual, and obtaining all necessary medical records from outside sources to ensure a thorough review and service eligibility.
• Complete all required paperwork for Medicaid TCM services, including service authorizations, assessments, evaluation, review, billing, and reporting.
• Complete a thorough client assessment, which includes the client’s strengths and weaknesses, family and community support systems, a Needs assessment that covers all areas described in the Adult Brain Injury Case Management Policy and Procedure Manual, and the assessment of existing resources presently utilized by the client and gaps in service’s requiring intervention within 45 days of opening a case.
• Obtains appropriate releases, understands the laws regarding confidentiality, and upholds these laws.