Long Term Care Services Specialist

General Description

This is a responsible non-exempt position on the staff of Senior Connection Center where exercising good judgment in evaluating situations and making decisions is very important.  Adept at interpreting and explaining complex information about Long Term Care (LTC), this professional position shall perform Long Term Care Medicaid service related activities which include intake, screening, potentially eligible individuals for enrollment and/or triage duties which inform eligible or potentially eligible individuals, their families and/or educating community partners about Medicaid covered services and how to obtain them.

Staff position is 100 percent (100%) Medicaid related and shall perform some or all of the following Aging and Disability Resource Center (ADRC) activities:

Responsibilities

• Accepts referrals from the Elder Helpline, as well as other resources for intake and screening as assigned by the Long Term Care Services (LTCS) Coordinator and/or Manager.
• Refers individuals in need of community resource assistance to the Elder Helpline.
• Determines the individual’s needs and screen for potential eligibility for Medicaid-related services utilizing a standardized screening instrument.
• Provides efficient, timely and consumer friendly services to facilitate the eligibility application and review process;
• Verifies an individual’s current Medicaid eligibility status for purposes of the Medicaid eligibility process.
• Explains Medicaid eligibility rules and the Medicaid eligibility process to prospective applicants.
• Conducts comprehensive screening on Medicaid probable individuals on the Assessed Priority Consumer List (APCL)
• Inputs client assessments into CIRTS (Client Information and Registration Tracking System).
• Posts information in the enrollment and termination screens of CIRTS to update the APCL as needed.
• Provides necessary forms and package all forms in preparation for Medicaid eligibility determination.
• Gathers information related to the application and eligibility determination for an individual, including resource information and third party liability information, as a prelude to submitting a formal Medicaid application.
• Assists individual in collecting and gathering required information and documents for the Medicaid application, this assistance may be provided in the individual’s home. The activity includes assisting the potential applicant, as a secondary resource to family members and care providers, in gathering information and completing an application for Medicaid benefits.
• Refers the individual to the local (or ADRC collocated) Department of Children and Families/Automated Community Connection to Economic Self-Sufficiency (DCF/ACCESS) staff to make application for Medicaid benefits. Coordinate with these staff regarding eligibility matters for Medicaid eligible or potentially eligible individuals.
• Assists in obtaining the Physical Referral form (3008) for Medicaid Waiver probable individuals and coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of functional eligibility.
• Collects, reviews and maintains accurate Medicaid eligibility determination tracking data to ensure completeness, accuracy and timeline.
• Tracks Medicaid applications through the eligibility process.
• Contacts individuals on the APCL as required to update information and screen for Medicaid eligibility.
• Participates in meetings with DCF, CARES and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process.
• Acts as a consumer advocate by coordinating with CARES and DCF/ACCESS staff to resolve in a timely manner any eligibly issues that arise during the Medicaid eligibility determination process.
• Standardizes and makes consistent outreach efforts to ensure public awareness of Medicaid programs and services and how to access them.
• Develops, compiles and distributes materials to inform individuals about the Medicaid programs, as well as how and where to obtain those benefits. Note: This activity does not include compiling information already available through the Medicaid agency or Department of Elder Affairs.
• Builds relationships with and educate service providers, professional entities and other professionals, such as hospital discharge planners and nursing home social workers, to facilitate referrals and increase awareness of Medicaid resources.
• Regularly meets with and training ADRC access points to increase awareness of Medicaid resources to individuals and target populations.
• Performs other Medicaid-related duties as assigned; which may include counseling disaster victims about Medicaid programs options and the eligibility process.
• Performs other related duties as required.

Minimum Education and Experience

• Minimum education and related experience:
  • Bachelor’s Degree; or
  • Associate’s Degree and two (2) years of experience; or
  • High School Graduate or Equivalent and four (4) years of experience
• Successful completion of applicable background screening required.
• Any exceptions to the minimum requirements must be approved by the President and CEO.

Required Skills and Knowledge

• Ability to communicate well, orally and in writing.
• Ability to research topics related to services for older adults (funding, program

design, etc.), analyze data and provide written and/or oral reports as required.

• Ability to establish and maintain effective working relationships with others.
• Basic skill level and knowledge of MS Office Suite including MS Word, Excel,

PowerPoint and database creation and maintenance either in Excel or

Access.

Physical Requirements

• Ability to work under stressful situations.
• Pleasant and clearly understandable telephone voice.
• Ability to lift and carry at least 10 pounds.
• Ability to operate a computer and other office equipment.
• Ability to sit at a desk for more than one hour at a time.
• Ability to bend and stoop in order to file and shelve.