Ada Labus

• Recruit, interview and hire new employees in accordance with company policy.
• Provide training to case managers and lead supervisors in accordance with regulations and program policy standards.
• Manage a team of 14-15 case managers and 2 case manager leads, ensuring regulations and program policy standards are met.
• Foster positive work environment, enhancing team morale and improving staffing stability.
• Conduct regular performance evaluations, providing constructive feedback and setting individual goals.
• Discuss job performance problems with staff, identifying causes and issues to find solutions.
• Resolve conflicts between case managers and participants by listening to grievances, identifying causes of disputes and implementing corrective actions as necessary. This includes communicating with DAIL to resolve grievances submitted directly to them.
• Lead monthly team meetings to discuss progress, address issues, and provide training to staff.
• Review and resolve participant complaints, ensuring prompt responses to inquiries. Maintain tracking system to identify patterns for systematic improvement. Resolve issues with representatives or participants while training staff as necessary.
• Guide case managers in handling difficult or complex problems with their caseloads. Assist with writing Corrective Action Plans and administering them to participants as needed.
• Identify and implement process improvements to streamline paperwork efficiency, updating packets, checklists, and cheat sheets to support team operations and enhance documentation clarity for easier navigation of procedures.
• Update MWMA, Database, and Navigation Plus, when staffing changes occur and at the beginning of the month when assigning participants to Case Managers and updating caseloads.
• Collect all Home Visit lists, review for all included/required information, complete mid-month review and end of month. End of month, update each Home Visit list to include recerts, required in-person visits, and required rep visits. Provide copy to finance for billing.
• Collaborate with quality assurance staff to outline care plan goals addressing recertification and employee packet issues ensuring documentation complies with regulations and policies.
• Attend DAIL and PDS Coordinators meetings when needed for training and guidance on regulation and program updates.
• Conduct bi-weekly reviews of timesheets and leave request forms.
  Manage vacation schedules while ensuring adequate coverage for sick leave and emergencies.
  Monitor staffing levels to address urgent staff needs effectively.
• Complete home visits with staff when needed for safety, issuing CAPS, assisting staff with documentation, and having a witness.
• During staff resignations or terminations: Conduct home visits to assess client needs and ensure service delivery compliance. Approve timesheets to guarantee accurate payroll processing for team members. Complete recertifications to maintain eligibility and program standards. Process employee packets and necessary paperwork.
• Prepare detailed fraud reports for OIG, including all required documentation.
  Supply written statements and additional documents as requested by OIG. Gather essential data to support efficient OIG investigations.
  Finalize incident reports and author CAPs when appropriate.
• Assist Program Manager with Audits, finding and providing information requested by designated deadlines.
• Assist staff when MP Waiver spots are allocated and participant must transfer from HCB Waiver to MP Waiver. Coordinate end/start dates and assist with paperwork needed, ensuring transfer completion and updating all systems.

Provided all case management activities for individuals receiving PDS and blended services for a caseload of approximately 45-50 participants.

• Assisted with training of participants and their contracted employees on the principles of self-determination and program regulations.
• Facilitated development and revision of participant service plans using person-centered planning to establish individualized goals aligned with their approved services.
• Oversaw participant compliance with service provision, ensuring adherence to service plans, prior authorization limits, and regulatory standards.
• Assured health, safety, and welfare of participant and compliance with the program guidelines.
• Developed corrective action plans for participants not complying with program guidelines or presenting safety risks.
• Reviewed and processed employee timesheets for all participants to ensure that services were provided in compliance with the participants' approved services, program policies, and Medicaid regulations.
• Assisted the participant with coordination of PDS, traditional waiver services, state plan services, and community resources.
• Completed program required face to face visits in participants' homes according to regulations. Monitored satisfaction with quality of services provided. Completed Team meeting to complete paperwork required for recertifications, employee packets, and plan of care modifications.
• Maintained comprehensive records for each participant, documenting case notes after home visits and additional correspondence as needed.
• Assisted DMS (Department of Medicaid Services) with outreach to and enrollment of participants into HCB and MP Waiver programs.
• Assisted the participant in developing the emergency back-up plan, including emergency service provisions.
• Provided technical support to the participant with managing their service plan and using the electronic visit verification system.
• Documented and completed incident reports when participants are taken to the ER, are hospitalized, or pass away.