TA Waiver RN Case Manager
Position Overview: TA Waiver RN Case Manager
Schedule: Full-Time (Monday through Friday, 8:00 AM – 4:30 PM; occasional evening/weekend community events as needed)
Location: Montgomery, AL area (Local travel approx. 25% required during normal business hours)
Classification: Professional Nursing / Case Management
About the Role
We are seeking an experienced, compassionate Registered Nurse (RN) Case Manager to lead clinical oversight and direct case management for our Technology Assisted (TA) Waiver program. In this vital role, you will champion person-centered care, partner with Medicaid to facilitate smooth client enrollments and transitions, conduct rigorous clinical case reviews, and support staff development to ensure the highest standards of quality and regulatory compliance.
Key Responsibilities
A. Administration & Clinical Leadership
Staff Training & Development: Identify clinical training needs to improve client health outcomes and professional competencies; train and re-educate case management staff as needed.
Team Communication: Assess team performance and support effective communication strategies to ensure program goals and health outcomes are successfully met.
Process Improvement: Provide clinical insights to management regarding quality assurance, compliance with policies, and adherence to state and federal regulations.
B. Case Management & Client Advocacy
Medicaid Enrollment: Collaborate directly with Medicaid to coordinate and enroll eligible clients into the TA Waiver program.
Comprehensive Assessments: Deliver one-on-one Long-Term Services and Supports (LTSS) case management by interviewing, assessing, and counseling clients and their families.
Person-Centered Planning: Develop individualized care plans and proactively monitor ongoing client progress.
Transitions & Coordination: Partner proactively with clients, families, and LTSS providers to ensure seamless, safe client transitions.
Documentation & Safety: Maintain thorough, up-to-date case records and promptly report any critical health-related incidents.
Community Resource Network: Build and maintain deep organizational knowledge of aging, adult resources, and healthcare providers to strengthen local referral pathways.
C. Clinical Review & Quality Assurance
Record Audits: Apply expert clinical judgment to review client medical records and case documentation.
Discrepancy Resolution: Identify clinical inconsistencies or documentation discrepancies, forwarding them to case managers for prompt physician follow-up, clarification, or correction.
Findings Reporting: Collect, organize, and document review findings to support internal quality controls.
Quality Collaboration: Partner with the In-Home Director and QA Manager (MW) to develop staff training modules, monitor the Transition Tracker, and conduct Person-Centered Care Plan (PCCP) reviews.
D. Administration & Compliance
Reporting: Prepare accurate program activity reports and administrative documentation in compliance with agency standards.
Professional Growth: Attend mandatory agency trainings, seminars, and organizational functions to maintain clinical excellence.
Qualifications & Requirements
Licensure: Must be a Registered Nurse (RN) with a current, active, unencumbered license in the State of Alabama.
Experience: Professional background in nursing, home health, long-term care, social services, or case management (familiarity with Medicaid Waiver programs and LTSS is strongly preferred).
Regulatory Knowledge: Working knowledge of state and federal regulations governing social services, healthcare, and benefit programs.
Core Competencies:
Exceptional clinical judgment and analytical skills to evaluate complex health situations.
Strong interpersonal skills with the ability to build effective working relationships with clients, families, public agencies, and multidisciplinary teams.
Excellent verbal and written communication skills.
High level of organization and adaptability to thrive in a fast-paced environment.
Physical Requirements & Working Conditions
Environment: Primarily sedentary office environment utilizing a computer and telephone.
Travel: Local travel of approximately 25% required during normal business hours for client visits and agency needs; valid driver's license and reliable transportation required.