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The Care Connection Specialist is responsible for assisting the person/family/advocate with the formal CCO intake and enrollment process. The Care Connection Specialist is responsible for informing the individual/family about Health Home Care Management, as well as HCBS Basic Plan support (if applicable), and assisting them in making an informed choice.
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Reviews criteria for OPWDD eligibility, and CCO Eligibility/Enrollment process with the person, and / or family member/advocate.
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Assists family with navigating OPWDD eligibility application process, and LCED application process. Obtain all necessary documentation, and facilitates obtaining missing assessments with community services providers.
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Reviews and Completes Health Home / CCO DOH enrollment forms with person/family. Completes HH CCO program enrollment within the OPWDD CHOICES system.
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Updates and maintains Intake Database, including tracking of required documents such as but not limited to; Eligibility, LCED, Letter of Introduction, (if applicable) Medicaid, DOH HH Consent forms.
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Maintains all relevant documents and documentation in Person’s record, including all phone contacts, correspondence, assessments, and reports.
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Complete all necessary paperwork related to enrollment, transfer, and discharge to/from the program.
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Support with community outreach, as needed, to connect with those individuals who are interested in information regarding CCO enrollment.
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Complies with OPWDD and DOH regulations pertinent to Care Coordination.
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Reports to supervisor and Care Connection management team the status of intakes.
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Establishes and maintains a community network between service providers internal and external to the Agency.
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Attends all required training in accordance with Agency and Departmental policies and procedures.
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Serves as a mandated reporter by reporting incidences of abuse, neglect, and maltreatment, and follows ACA/NY OPWDD untoward incident reporting procedures.
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Adheres to standard safety practices of job, department, and Agency policies and procedures related to safety.
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Provide support to ensure the correct type of Medicaid is secured to receive OPWDD eligible services. This may include completion of Medicaid applications, parental deeming, support with processing, follow up activities as needed.
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Work with supervisors to support capacity management and to identify current availability by region.
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Provide information to supervisor for enrollment trend reporting.
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Participate in planning activities with the Care Management team and share recommendations for ensuring seamless enrollment.
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Form and maintain working relationships with all OPWDD Regional Offices, with the goal of ensuring that ACANY is positioned as a responsive CCO when a referral is needed.
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Provide referral information for those who require a different service model.
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Attend department/team meetings, trainings, supervisions, etc. as scheduled and in accordance with agency practice and policy. Complete all required trainings within required timeframes.
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Travel throughout the designated service area to meet with people interested in receiving services as needed.
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Maintain confidentiality.
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Perform other duties as assigned.
