As a wholly-owned subsidiary of Family Health Network, a non-for-profit provider sponsored HMO in Illinois; Community Care Alliance of Illinois was created to meet the complex care needs of individuals. People with psychiatric, physical, sensory and developmental disabilities and multiple chronic illnesses in publicly funded insurance systems (either Medicaid or dual eligible - e.g., both Medicare/Medicaid) will be our members. We are currently seeking a Long-Term Services & Support Coordinator to join our team.
Long-Term Services & Support Coordinator
The LTSS Coordinator is responsible for coordinating long-term services and supports, home and community-based waivers and health and wellness classes. This includes keeping documentation and records updated and implementing programs and services according to waiver rules and regulations. Serves as an active advocate for the Enrollees’ rights to live independently in the most integrated and least restrictive environment. Offers guidance and support to Enrollees to help them function the best way they can within their environment. Plays a key role in the interdisciplinary care team and is a resource to the Enrollee and their families and support systems.
Complete Health Risk Assessments and develop individualized care plans: assess needs and develop goals of care with the Enrollee and/or their families or guardians, and interdisciplinary team; complete telephonically or in a hospital, home, or other community setting.
Develop and implement home- and community-based waiver service plans in accordance with waiver program guidelines
Engage Enrollees to take an active role in their own care plan and to ensure individual goals of care and services provided for the safety of the Enrollee while empowering the Enrollee’s abilities to exercise choice and make decisions.
Keep accurate and detailed notes and records for each Enrollee through documentation in electronic case management system.
Serve as a key resource to Enrollees, their families, guardians and PAs and must be knowledgeable about community resources, social service programs for seniors and all people with disabilities.
Consult with interdisciplinary team members such as primary care physicians, nurse care coordinators, specialists, behavioral health coordinators, peer navigators and other health care professionals.
Ensure consistency of services for individuals served by working cooperatively with other program areas and waiver departments and providers such as Aging, DHS-DRS (Brain Injury Program, HIV/AIDS, People with Disabilities under 60 years of age and Developmental Disabilities) Centers for Independent Living, PAS agencies, Nursing Homes and Supported Living Facilities.
Identify Enrollees who wish to transition from nursing homes to a community setting in conjunction with Money Follows the Person Transition Program Coordinators, Community Reintegration Program Coordinators, Nursing Home staff and PCP.
Maintain familiarity with services available to consumers including eligibility requirements and appeal procedures for HCBS Waivers and Nursing Home Transition Program Coordinators. Communicate with families, case managers, and individuals served regarding the rules as they apply to services.
Communicate with individuals served, guardians, and case managers in a timely manner regarding changes in service provision, limitation of rights, or other concerns regarding the individual.
Ability to travel within service area.
General good health.
Able to participate in training sessions, presentations, and meetings.
Travel will be required for the purpose of meeting with Enrollees, stakeholders, or off-site personnel/management.
Bachelor’s degree required; Master’s degree preferred (social work, social sciences, counseling or human services related field)
Experienced in case management or care coordination, preference for experience with the Medicaid and Medicare populations
Bilingual in Spanish is a plus
Knowledge of Microsoft Office suite.
Must possess solid communication skills.
Excellent problem-solving skills
Willingness to adhere to all principles of confidentiality.
Must value operating in a collaborative and cooperative environment.
Ability to show initiative, good judgment, and resourcefulness.
Family Health Network, Inc. is a not-for-profit provider sponsored HMO providing healthcare benefits to participants in many of the programs covered under the State of Illinois Department of Healthcare and Family Services