Long-Term Care Functional Screen Specialist
Our Inclusa team is looking for aLong-Term Care Functional Screen Specialist to join us!Who is Inclusa?Inclusa serves communities across Wisconsin, through the provision of a person-centered and community-focused approach to long-term care services and supports for over 15,000 Family Care Members across its 68-county service region.
For two decades, Inclusa has offered the Family Care benefit to eligible elders and adults with disabilities.
As a values-based organization, devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a focus on the belief in everyone.
With 30
offices throughout the state and a growing workforce, Inclusa has created a workplace founded on the belief in the strengths, gifts and contributions of everyone, where all people can explore and pursue employment possibilities.
Here at Inclusa, every position is essential in supporting Inclusa's:
Vision:
Inclusa empowers people to explore and achieve life's possibilities.
Mission:
In order to maximize health outcomes, Inclusa proactively partners with others to build vibrant and inclusive communities that offer people dignity, choice, and connections.
Values:
Partnership, Respect, Innovation, Integrity, Development, and Excellence.
This LTC Functional Screen Specialist role uses a tool designed by the State Department of Health Services (DHS) to assess functional status, level of care, and ongoing eligibility of Family Care members.
The individual transmits internal updates as warranted to ensure appropriate updates to acuity-based provider payment rates and appropriate reimbursement to Inclusa, Inc.
via the per member per month capitation payment from DHS.
When warranted, refers members to other internal staff for individualized assistance that ensures member healthy and safety, or continuity of care for members who experience a change that impacts level of care or ongoing eligibility for benefits.
Selected individual must meet requirements and successfully complete online screener certification training course(s) and become certified as a functional screener.
Primary responsibilities but not limited to Upon assignment, schedules appointments with members to complete an annual re-determination of functional eligibility, or a re-determination of eligibility based on changes in functional abilities reported by Member Support Coordination (MSC) staff.
Screens are expected to be scheduled in a manner which maximizes organizational resources, including time/travel expenses.
Uses the screening tool designed by DHS to gather information about each individual's functional abilities, health status, and personal and professional supports required to meet his or her desired level of functioning.
Pending the revelation of needs or concerns beyond the scope of the functional screen, refers members to staff of Inclusa or an Aging and Disability Resource Center.
Responds to urgent situations and refers individuals for crisis intervention, as necessary.
Maintains up-to-date online member information regarding functional abilities, demographics, and appropriate contacts.
Works directly with MSC staff to ensure consistency between the information gathered during a member's functional assessment and member-specific data contained in internal records.
Conducts face-to-face interviews with individuals, usually in their homes, to perform the functional screen.
Enters the information gathered into an internet-based program that, based on the data collected during a face-to-face interview, calculates a level of care for the individual.
Provides appropriate notice of member rights, in accordance with contractual requirements, to members who experience a change in level of care that may impact the benefit package one is entitled to or overall program eligibility.
Submits timely, accurate, and complete documentation in accordance with established guidelines and processes.
Attends meetings and training as needed or required to maintain knowledge of agency processes, the long-term care functional screening tool, and/or any changes to process or the screening tool resulting from new state directives.
Participates in quality assurance activities that ensure competence and inter-rater reliability among all staff certified to use the statewide long-term care functional screen tool.
Once obtained, maintains certification to complete functional eligibility screens by completing and passing continuing skills testing as required by the State of Wisconsin.
Applies good professional judgment in documentation by demonstrating respect for members and maintaining screen integrity when reviewing and completing assessments.
Coverage area will be in South Central Wisconsin.
Please be advised that Inclusa, Inc.
employees will become employees of Humana, Inc.
January 2024What's in it for you by joining the Inclusa team? Flexible employment model - local remote work options wherever it's most convenient to get the work done! Work/life blend - we operate Monday - Friday 8:
00 am - 4:
30 pm and understand our new normal work environment may include new co-workers (like family members, fur children, roommates, etc.
) AND that's ok! Various paid time off through accrued PTO time & 10 recognized holidays and additional floating holidays.
Customize your insurance needs - medical, vision, and dental options to fit your family.
Life insurance covered 100% by Inclusa.
Short term and long-term disability insurance covered 100% by Inclusa.
Financial perks - 401K plan is dollar to dollar matched up to 4%.
Casual dress code policy - dress appropriately per your schedule.
Our members - the biggest benefit of all is that you are making a difference by supporting members in your local community.
Passion
Giving back to those most in need = Fulfilling your life's best work! It just makes sense!Questions about this rewarding role can by answered by contacting our Talent Acquisition Specialist, Suzanne Pierce at email protected .
Recommended Skills Assessments Contract Management Crisis Intervention Long Term Care Quality Management Reliability Estimated Salary: $20 to $28 per hour based on qualifications.
For two decades, Inclusa has offered the Family Care benefit to eligible elders and adults with disabilities.
As a values-based organization, devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a focus on the belief in everyone.
With 30
offices throughout the state and a growing workforce, Inclusa has created a workplace founded on the belief in the strengths, gifts and contributions of everyone, where all people can explore and pursue employment possibilities.
Here at Inclusa, every position is essential in supporting Inclusa's:
Vision:
Inclusa empowers people to explore and achieve life's possibilities.
Mission:
In order to maximize health outcomes, Inclusa proactively partners with others to build vibrant and inclusive communities that offer people dignity, choice, and connections.
Values:
Partnership, Respect, Innovation, Integrity, Development, and Excellence.
This LTC Functional Screen Specialist role uses a tool designed by the State Department of Health Services (DHS) to assess functional status, level of care, and ongoing eligibility of Family Care members.
The individual transmits internal updates as warranted to ensure appropriate updates to acuity-based provider payment rates and appropriate reimbursement to Inclusa, Inc.
via the per member per month capitation payment from DHS.
When warranted, refers members to other internal staff for individualized assistance that ensures member healthy and safety, or continuity of care for members who experience a change that impacts level of care or ongoing eligibility for benefits.
Selected individual must meet requirements and successfully complete online screener certification training course(s) and become certified as a functional screener.
Primary responsibilities but not limited to Upon assignment, schedules appointments with members to complete an annual re-determination of functional eligibility, or a re-determination of eligibility based on changes in functional abilities reported by Member Support Coordination (MSC) staff.
Screens are expected to be scheduled in a manner which maximizes organizational resources, including time/travel expenses.
Uses the screening tool designed by DHS to gather information about each individual's functional abilities, health status, and personal and professional supports required to meet his or her desired level of functioning.
Pending the revelation of needs or concerns beyond the scope of the functional screen, refers members to staff of Inclusa or an Aging and Disability Resource Center.
Responds to urgent situations and refers individuals for crisis intervention, as necessary.
Maintains up-to-date online member information regarding functional abilities, demographics, and appropriate contacts.
Works directly with MSC staff to ensure consistency between the information gathered during a member's functional assessment and member-specific data contained in internal records.
Conducts face-to-face interviews with individuals, usually in their homes, to perform the functional screen.
Enters the information gathered into an internet-based program that, based on the data collected during a face-to-face interview, calculates a level of care for the individual.
Provides appropriate notice of member rights, in accordance with contractual requirements, to members who experience a change in level of care that may impact the benefit package one is entitled to or overall program eligibility.
Submits timely, accurate, and complete documentation in accordance with established guidelines and processes.
Attends meetings and training as needed or required to maintain knowledge of agency processes, the long-term care functional screening tool, and/or any changes to process or the screening tool resulting from new state directives.
Participates in quality assurance activities that ensure competence and inter-rater reliability among all staff certified to use the statewide long-term care functional screen tool.
Once obtained, maintains certification to complete functional eligibility screens by completing and passing continuing skills testing as required by the State of Wisconsin.
Applies good professional judgment in documentation by demonstrating respect for members and maintaining screen integrity when reviewing and completing assessments.
Coverage area will be in South Central Wisconsin.
Please be advised that Inclusa, Inc.
employees will become employees of Humana, Inc.
January 2024What's in it for you by joining the Inclusa team? Flexible employment model - local remote work options wherever it's most convenient to get the work done! Work/life blend - we operate Monday - Friday 8:
00 am - 4:
30 pm and understand our new normal work environment may include new co-workers (like family members, fur children, roommates, etc.
) AND that's ok! Various paid time off through accrued PTO time & 10 recognized holidays and additional floating holidays.
Customize your insurance needs - medical, vision, and dental options to fit your family.
Life insurance covered 100% by Inclusa.
Short term and long-term disability insurance covered 100% by Inclusa.
Financial perks - 401K plan is dollar to dollar matched up to 4%.
Casual dress code policy - dress appropriately per your schedule.
Our members - the biggest benefit of all is that you are making a difference by supporting members in your local community.
Passion
Giving back to those most in need = Fulfilling your life's best work! It just makes sense!Questions about this rewarding role can by answered by contacting our Talent Acquisition Specialist, Suzanne Pierce at email protected .
Recommended Skills Assessments Contract Management Crisis Intervention Long Term Care Quality Management Reliability Estimated Salary: $20 to $28 per hour based on qualifications.
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