Case Manager

Essential Duties & Responsibilities

Member Services & Care Coordination

Conduct initial welcome calls to all newly assigned members to introduce A1 Homecare Services and confirm service expectations.

Complete, review, and maintain Plans of Care (POC) with members and/or their POA.

Ensure members understand:

Their caregiver(s)

-

- Authorized hours and schedules

- Duties being performed

- Maintain ongoing communication with members to address concerns, missed visits, or changes in condition.

- Document all member contacts accurately and timely in HHA Exchange and the member chart.

Caregiver Oversight & Support

Confirm caregivers are:

Active and compliant in HHA Exchange

Properly assigned to members

Aware of duties and schedules

Ensure caregivers:

Use EVV correctly (mobile app vs. call-in)

Leave appropriate notes at clock-in/out

Coordinate caregiver training, retraining, and EVV education as needed.

Identify caregiver performance issues and initiate Corrective Action Plans (CAPs) when necessary.

Compliance & Regulatory Responsibilities

Ensure compliance with HCBS Codes 257, 262, and 265.

Monitor and audit:

EVV clock-in/clock-out accuracy

GPS discrepancies

Missed visits and late documentation

Maintain accurate member charts, including:

Signed POCs

Backup caregiver policies

Member and caregiver signatures

Assist with audits, MCO reviews, and internal compliance checks.

Prepare and issue required notices (e.g., 10-day notices) in coordination with leadership.

Authorization & Utilization Management

Review authorizations and ensure services align with approved hours.

Monitor over-utilization and under-utilization reports.

Communicate with supervisors regarding authorization changes, service gaps, or discharge needs.

Ensure schedules are accurate and reflect current authorizations.

Documentation & Reporting

Maintain clear, timely, and compliant documentation in all systems.

Update member phone numbers, addresses, and caregiver information promptly.

Complete daily, weekly, and monthly assigned reports.

Escalate risks, behavioral concerns, or service disruptions immediately.