DS Eligibility Specialist

DS Eligibility Specialist

SUMMARY

This is a full-time non-exempt position that is responsible for completing the intake, eligibility and enrollment for Office of Developmental Programs (ODP) ID/A and ASD Waivers; act as a Qualified Developmental Disabilities Professional (QDDP) to complete level of care determinations to establish waiver eligibility and continued eligibility.  These functions are competed for individuals’ birth through adulthood, with a diagnosis of intellectual disability, autism spectrum disorder and developmental disabilities 0 to 8 years of age. This position will take a lead role in assisting individual/families using the LifeCourse Framework tools and provide guidance on resources with individuals and families at the time of intake. This position will also assume the role of an Office of Developmental Programs Certified Investigator to comply with ODP Incident Management requirements. These services will be provided to individuals and their families who live in or receive services in Westmoreland County.  All services will be based on the philosophies and concepts of Positive Approaches, Everyday Lives and Supporting families throughout the Lifespan.  Primary work hours will be Monday through Friday, 8:30 am to 4:30 pm with a 1/2 hour lunch (37.5/week) unless otherwise agreed upon.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Includes the following, (other duties may be assigned as deemed necessary by management):

Compliance:
Adheres to RIHS, county, state, and federal including HIPAA regulations governing Developmental Services. Attends specially designed training programs provided through RIHS, county, state, and federal including HIPAA agencies.

Advocacy Activities:

This position will help consumers and their family navigate the system, removing barriers and creating options for resolving problems when necessary.  They will work to ensure consumers receive appropriate resources, information and referral when requested.

Intake and Referral Coordination:
Receives all information and referral requests for individuals who live in Westmoreland County and are seeking services coordinated through Westmoreland County’s Developmental Services Program, birth through adulthood.  This position must schedule all referrals as required to conduct initial registration to determine eligibility; diagnosis of intellectual disability, autism spectrum disorder or developmental disabilities 0 to 8 years of age.  This will be done by obtaining releases to secure all permanent and diagnostic records from outside agencies; schedule psychological testing if needed; prepare social history along with LifeCourse Framework tools; compile all documents required to include in a medical record; offer Medical Assistance and assist with paper or on-line application if needed.

Resources:

Assist DS Family Resource Specialist in providing resources with the targeted populations and the community at large and assist with Everyday Lives and Supporting Families Throughout the Lifespan principles. Assist in identifying newsletter communications for on the agency website and thru distribution.

Assessments:

Maintain access and knowledge of the Support Intensity Scale (SIS) and PA Plus assessments to be able to complete the annual waiver reassessments using the designated tool. Obtain training on administration and scoring of a standardized assessment of adaptive functioning tool and maintain adequate knowledge to safeguard accurate results. Ability to read and interpret standardized diagnostic and general intelligence testing. Ability to engage discussion with the psychologist about collected records when diagnosis clarification is being determined. Maintain regulatory knowledge and ability to complete Level of Care determinations to establish waiver eligibility and continued eligibility.

Certified Investigations:

Become a certified investigator by passing the required testing through Office of Developmental Programs. Maintain that certification to complete investigations as assigned by Manager. Required to conduct thorough investigations as per ODP Incident Management Bulletin. These investigations my occur in residences, personal care homes, long-term care facilities and nursing homes. It will also involve documentation as required by bulletin. Confidentiality must be maintained at all times and respect of the rights of all parties is essential.

Qualified Developmental Disability Professional (QDDP):

Act as the agency’s QDDP and take responsibility for all related activities which include Waiver Evaluations/Reevaluations and Service Delivery Preference.

Home and Community Services Information System (HCSIS)

Possess necessary computer skills to successfully navigate the web based system.  Responsible for completing the registration information and eligibility sections in HCSIS. Responsible to document all work activity including contracts and meetings for each eligible individual.

Data Base/Record Keeping:
Responsible for the maintenance and update to consumer information system as needed and required. Maintain documentation for compliance with regulations. Efficiently complete paperwork and other program related materials.

Professional/Technical Responsibilities:

Extensive knowledge of the BH/IDD service system; IDD and accepted methods of intervention; ability to prioritize work and meet deadlines; ability to establish and maintain effective working relationships with referrals, families, SCO, AE, psychologist, service providers and regulatory bodies. This position will obtain certification through the Office of Developmental Programs and assume the role of a Certified Investigator to comply with ODP Incident Management requirements.  It will also participate in quarterly peer reviews of reportable incidents and maintain certification as required.

Other Duties:

This position may be required to perform other duties as assigned by the supervisor or management staff.

QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience: as required by Office of Developmental Programs (ODP) regulation to qualify as a Qualified Developmental Disabilities Professional (QDDP)

  • A master’s degree or higher level of education from an accredited college or university and one year of work experience working directly with persons with disabilities;
  • A bachelor’s degree from an accredited college or university and two years work experience working directly with persons with developmental disabilities; or
  • An associate’s degree or 60 credit hours from an accredited college or university and four years work experience working directly with persons with developmental disabilities.

Excellent communication, time management and computer skills.

Language Skills:
Strong interpersonal skills, effective oral and written communication skills.  Ability to prepare clear, concise reports.  Working knowledge of computer software that includes databases, spreadsheets and word processing for tracking information and preparing reports, letters and forms.  Effectively present information, and respond to questions from consumers, families, agency, county, and state representatives.

Certificates, Licenses, Registrations:
Valid PA driver’s license, Proof of valid Auto Insurance, ACT 33 (Child Abuse), ACT 34 (Criminal Record) and FBI Clearance.  There will be monthly screenings of PA Medicheck List, LEIE and EPLS.

Physical/Mental Demands:
While performing the duties of this job, the employee is regularly required to operate a motor vehicle, sit, stand, walk, bend and lift objects of up to 10 pounds. The employee regularly uses a computer, phone, fax, copier and other essential office equipment to carry out daily work assignments.

Work Environment:
While performing the duties of this job, the employee regularly works in an office environment. The employee may be required to work outside the office environment in relation to needs of the providers, consumers and/or regulating agencies.  Exposure to outside weather conditions will exist.  The noise level in the work environment is usually moderate.

Reasonable Accommodation:

It is WCSI’s business philosophy and practice to provide reasonable accommodations, according to applicable state and federal laws, to all qualified individuals with disabilities.

 

 

Job Type: Full Time Non Exempt
MCR Code: P3002
Supervisor: RIHS Developmental Services Manager
Department: Developmental Services

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