Home and Community Based Services Manager
Company: KEPRO (The Keystone Peer Review Organization), Inc
Posted on: February 23, 2021
If you are a job seeker with a disability and require a
reasonable accommodation to apply for one of our jobs, you will
find the contact information to request the appropriate
accommodation by visiting the following page: Home and Community
Based Services Manager KEPRO is a rapidly growing national quality
improvement and care management organization. We work to ensure
that over 20 million people receive the right care, at the right
time, in the right setting.---KEPRO is seeking resumes for a highly
experienced HCBS/LTSS management professional. Home and Community
Based Services Manager Summary Description Under the direction of
the Program Director of the Colorado Utilization Management
Program, this position provides overall leadership for Long Term
Support Services and Home and Community-Based Waiver UM program
activities for a contract with the Colorado Department of Health
Care Policy and Financing Office of Community Living, serving
Colorado Medicaid members. The LTSS Manager oversees a department
including, at a minimum, Children's Extensive Support waiver, Home
and Community-Based Services waivers, Over-Cost Containment
reviews, Critical Incident reviews, and In-Home Support Services
Cost Containment reviews. Accountabilities
- Assures accuracy and timeliness of all applicable review type
cases within contract requirements.
- Assesses, evaluates and addresses daily workload and queues;
adjusts work schedules daily to meet the workload demands of the
- Analyzes productivity of reviewers conducting reviews of
Enrollees' long-term supports and services (LTSS) and/or Home and
Community-Based Services (HCBS) needs and monitor the provision and
outcomes of those services, including quality of outside agency
- Identify clinical staff orientation and continuous learning
needs and in collaboration with the Program Director, develops and
implements plans to address those identified learning needs.
- In collaboration with Program Director, responsible for the
quality monitoring activities including identifying areas of
improvement and plan implementation of improvement areas.
- Maintains current knowledge base related to review processes
and clinical practices related to the processes; functions as the
initial resource to assigned clinical staff regarding all review
process questions and/or concerns.
- Functions as provider liaison and contact/resource person for
provider customer service issues and problem resolution.
- Performs all applicable review types as workload
- Foster positive and professional relationships and act as
liaison with internal and external customers to ensure effective
working relationships and team building in order to facilitate the
- Attends training and scheduled meetings and for maintenance and
use of current/updated information for review.
- Maintains current knowledge base related to LTSS/HCBS review
and assessment processes and clinical practices related to the
- Cross trains and perform duties of other contracts within KEPRO
to provide a flexible workforce to meet client/customer needs. The
list of accountabilities is not intended to be all-inclusive and
may be expanded to include other duties that management may deem
- Active unrestricted RN, Licensed Social Worker or other
applicable State and/or Compact State clinical license per contract
- Graduation from an accredited Associates or Bachelor's Degree
- Case Management Certification preferred.
- Behavioral Health (adult or pediatric), TBI, LTSS, or HCBS
- Health-related Master's Degree preferred. Knowledge, Skills,
- Knowledge of current NCQA/URAC standards strongly
- Knowledge of the organization of medical records, medical
terminology, and disease process required.
- Strong clinical assessment and critical thinking skills
- Medical record abstracting skills required.
- Ability to work in a team environment.
- Flexibility and strong organizational skills needed.
- Must be proficient in MS Office and internet/web
- Work effectively with individuals with diverse disabilities and
- Problem solve and prioritize and meet deadlines.
- Familiarity with Independent Living issues and philosophy.
- Familiarity with Community resources and local service system
for persons with disabilities.--- Experience---
- Minimum of 3 years of clinical experience in a home care,
skilled nursing facility, community-based Care Management, or
residential care environment required.
- Minimum of 2 years health system quality management or related
- Minimum 3 years direct behavioral/mental health experience in a
clinical setting or other applicable State and/or Compact State
clinical experience or license per contract requirements.
- Previous workload management experience required.
- Experience with State Medicaid programs strongly preferred.
Mental and Physical Requirements The physical demands described
here are representative of those that must be met by an employee to
successfully perform the essential functions of this job.
Reasonable accommodations will be made as required by law in an
attempt to enable an individual with a disability to perform the
essential functions of this job. While performing the duties of
this job, the employee is regularly required to sit for prolonged
periods of time; key and/or control objects; interact extensively
with internal and external customers; occasionally lift and/or move
objects weighing up to 10 pounds; and occasionally travel within
the state. KEPRO offers challenging careers, excellent benefits and
opportunities for advancement. For consideration, please submit
resume and cover letter with salary requirements.---Only those
candidates identified for an interview will be contacted.---No
Phone Calls Please. Visit our website at---www.KEPRO.com---for more
information on the KEPRO Family of Companies. EOE AA
M/F/Vet/Disability KEPRO is and Equal Opportunity Employer. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, or status as a
protected veteran. Equal Opportunity Employer/Protected
Veterans/Individuals with Disabilities The contractor will not
discharge or in any other manner discriminate against employees or
applicants because they have inquired about, discussed, or
disclosed their own pay or the pay of another employee or
applicant. However, employees who have access to the compensation
information of other employees or applicants as a part of their
essential job functions cannot disclose the pay of other employees
or applicants to individuals who do not otherwise have access to
compensation information, unless the disclosure is (a) in response
to a formal complaint or charge, (b) in furtherance of an
investigation, proceeding, hearing, or action, including an
investigation conducted by the employer, or (c) consistent with the
contractor's legal duty to furnish information. 41 CFR
Keywords: KEPRO (The Keystone Peer Review Organization), Inc, Denver , Home and Community Based Services Manager, Executive , Denver, Colorado
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