Appeals Intake Jobs in Virginia (NOW HIRING)

Benefits:

• Health insurance
• Vision insurance
• Dental insurance

Great news! The Agency Directed Services department at DePaul Community Resources is growing! DePaul is seeking a full-time ADS Case Manager that will serve the Roanoke or Christiansburg regions, 37.5 hours per week JOB SUMMARY:
The primary function of the Case Manager will be to complete and review required case record documentation, work with referral sources and market services, and provide support to families in the Agency Directed Services program. The Case Manager will provide support related to specific case record documentation of the nurses in identified office locations. The position does not participate in field-related work. The Director delegates tasks assigned to this position based on the needs and size of caseloads of nurses. This position is primarily based out of the Roanoke office, with the ability to work remotely as a hybrid arrangement agreed upon with the program director.
SUPERVISION RECEIVED AND EXERCISED:
The Case Manager reports directly to the Director of Agency Directed Services.
ESSENTIAL FUNCTIONS AND DUTIES:
This list is not exhaustive or all-inclusive of job responsibilities. The time allotted for any function or duty is subject to change with or without notice. Nothing in this job description restricts management's right to assign other responsibilities to this job or reassign them elsewhere at any time.

• Create and maintain caregiver profiles, uploading new client packets in CareSmartz 360.
• Prepare paperwork for intake visits and other visits as needed.
• Scan and upload approvals, denials, and appeal information into CareSmartz 360, working closely with finance on obtaining appropriate service authorizations.
• Speak with referral sources and potential new referrals about the services.
• Speak with social services workers about Medicaid eligibility of clients on ADS caseload.
• Participate in meetings related to program growth and expansion and identification of needed resources.
• Attend marketing events representing ADS.
• Work with CareSmartz 360 to identify and implement needed improvements for the program.
• Provided support to staff and families by assisting personal care attendants with the completion of paperwork and scheduling visits.
• Make calls to follow up with clients and families as needed and document these interactions in CareSmartz 360.
• Participate in interviews with potential personal care attendants as requested.
• Check references for potential personal care attendants and create other hiring documents as requested.
• Conduct drug screens on personal care attendants as needed.
• Attend program and team meetings as required and requested.
• Meet regularly with the program director to discuss referrals, service provision, program needs, and potential concerns regarding service delivery.
• Complete other duties within the scope of the program as assigned.

KNOWLEDGE, SKILLS, ABILITIES & OTHER CHARACTERISTICS REQUIRED:
Knowledge, skills, abilities, and other characteristics or KSAOs are attributes needed to perform a job that is demonstrated through qualifying training, education, and experience. This list is not an exhaustive & all-inclusive list of all KSAOs for this job.
Knowledge of:

• Records administration techniques and procedures
• The structure and content of the English language, including the meaning and spelling of words, rules of composition, and grammar
• Microsoft Office Word, Excel, PowerPoint, Outlook, SharePoint, and virtual meeting applications such as Zoom
• Knowledge of Medicaid waivers and agency directed services
• DePaul's policies, procedures, and standard practices and the rules and guidelines established by regulatory and governing agencies such as VDH, DMAS, DBHDS, HCBS, and DSS
• Relevant policies, procedures, and strategies to promote the safety and protection of people, data, and property

Skill/Ability to:

• Give full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times
• Verbal and written communication and body language that conveys information, ideas, or inquiries effectively and concisely that purveys professional composure, emotional intelligence, thoughtfulness, patience, and respect amidst change, ambiguity, and within the daily trajectories of work
• Use of standard office equipment such as telephone, calculator, printer, scanner, cellular phone, tablet, laptop, postage machine, shredder
• Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems
• Collect and analyze dataTime management, managing multiple priorities, and completing assignments on time, accurately, and with attention to detail
• Work collaboratively within a team environment and build strategic relations with coworkers and management
• Communicate effectively in both oral and written form
• Understand and follow verbal and written instructions and directives from supervisors, guidelines, and operating procedures that may be maintained or modeled by managers, peers, and lead staff
• Operate a computer with a general understanding of MS Office Suites, virtual meeting software, the Internet, and department or program-specific software
• Develop objectives, evaluate effectiveness, and assess needs
• Recognize, analyze, and problem-solve ambiguous or difficult situations and questions using critical thinking while maintaining professional composure
• Analyze and prepare concise and accurate documents, reports, and correspondence

Other Characteristics:

• Demonstrate self-awareness, ongoing self-evaluation, and a commitment to being part of a diverse, equitable, respectful, and inclusive workplace where all people are valued
• Demonstrate professional composure in difficult and stressful situations
• Demonstrate the FIRST (fairness, integrity, respect, safety, trust) values in the daily trajectories of work
• Demonstrate professionalism regarding access to sensitive and confidential information related to employees, clients, and business records, with no disclosure to others without their knowledge.

MINIMUM REQUIREMENTS TO APPLY:
An Associate's degree with experience working in human service programs or organizations that serve individuals with disabilities or aging populations is required. A comparable combination of professional and/or personal experience and education may be considered.
WORK ENVIRONMENT:
The work environment characteristics described herein represent those an employee encounters while performing the position's essential functions. The employee regularly works in an office environment and occasionally in the field. Work is generally completed regularly during weekdays; however, daily work hours will vary. Work is subject to frequent interruptions, and noise levels are varied based on the work locations.
PHYSICAL REQUIREMENTS:
The physical demands described herein are representative of those that an employee in this position must meet, with or without reasonable accommodations, to perform the essential functions successfully. Physical activities required are finger dexterity necessary to operate equipment used in the position, effective communication and seeing or hearing verbal cues. Walking up to one-third of the time, sitting at least two-thirds of the time, bending up to one-third of the time, stooping rarely, and lifting/pushing/pulling up to ten pounds. When accessing various locations, the incumbent must climb stairs and ramps. This position requires driving approximately ten percent of the employee's working time to various locations. Public transportation may not be available. Individuals needing reasonable accommodations should speak with their immediate supervisor/hiring manager.
SPECIAL REQUIREMENTS AND QUALIFICATIONS:
The following may be required after a conditional job offer: current DMV driving record with results that comply with insurer guidelines; drug and alcohol screening with satisfactory results stipulated by applicable governing, funding, or regulatory agencies; criminal history background report. The applicant shall not have been convicted of any barrier crime(s) on the criminal background report.
NOTE:
This description provides information regarding the essential functions of the designated job and the general nature and level of work associated with the job. It should not be interpreted to describe all the duties whose performance may be required of such employees or be used to limit the nature and extent of assignments such an individual may be given.
DePaul is an Equal Opportunity Employer and E-Verify Participant
Flexible work from home options available.
Compensation: $22.11 - $24.11 per hour
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, age, religion, color, gender, ethnic or national origin, physical or mental disability, marital status, pregnancy, childbirth, or a medical condition related to pregnancy or childbirth, veteran status, sex, sexual orientation, gender identity, gender, genetic information, political affiliation, or any other classification protected by law.
For 40 years, DePaul Community Resources has opened doors to hope and belonging for families and individuals across Central and Southwest Virginia. We are not only a nonprofit human services organization-we are a social impact organization. Every day we work to change the world by improving the lives of children, families, and individuals with developmental disabilities. With dedicated staff, care providers, foster and adoptive parents, and a host of volunteers, advocates, and partners, it is work that we cannot accomplish alone. Hope and belonging is for all of us-with your help, we can make this vision a reality for countless Virginians who cannot imagine it today.
DePaul Community Resources is a nonprofit, 501(c)(3) organization.
All applicants shall be afforded equal opportunity in all aspects of employment, volunteer opportunities, and internships without regard to race, age, religion, color, gender, ethnic or national origin, physical or mental disability, marital status, pregnancy, childbirth, or a medical condition related to pregnancy or childbirth, veteran status, sex, sexual orientation, gender identity, gender, genetic information, political affiliation, or any other classification protected by law. DePaul is an E-Verify employer. The unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the workplace. Failure to comply will result in dismissal from the property and/or employment.