Manager for Personal Care Management Evaluation Department

The Program Manager for the PCM Evaluation Department is a Registered Nurse who oversees the Evaluation services to people with disabilities applying to or reapplying to the MassHealth Personal Care Attendant Program. The position is responsible for quality assurance, process improvement, project and report management for the PCA Program as well as for providing appropriate training as it applies to following regulation and/or processes changes.

• $75, 000 - $85, 000 salary range
• In person for 3 weeks training in Stoughton, MA office
• Hybrid after training 2 days in office
• Core hours and days
  • 8: 30am to 4: 30pm
  • Monday - Friday

Essential Functions

• Assure high quality supports by providing direction and supervision in all aspects of the PCA Evaluation process.
• Organize staff and staffing functions to provide appropriate, efficient and quality PCA evaluation services.
• Monitor scheduling of staff to ensure economy and efficiency of consumer contact and Evaluation Department coverage.
• Monitor and improve job performance of all Evaluation Department staff. Offer constructive feedback on regular basis and conduct performance evaluations in a timely manner.
• Working closely with IT department to ensure appropriate technical solutions and improvements are provided to Evaluation Department staff.
• Educate consumers and healthcare providers on PCA Program regulations.
• Offer insight, support and provide education to fellow colleagues regarding Evaluation Department functions.
• Oversee complaint policy for PCA consumers or surrogates.
• Manage administrative processes and requirements in consultation with Human Resources, Information Technology and Compliance departments.
• Responsible for quality assurance of the PCA Program performance, provide feedback and suggestions for improvement to Director of Community Services.
• Design metrics to track quality of the PCA Program performance according to contract and related to Evaluation Department services.
• Review time worked, and Calendars when verifying biweekly payroll.
• Review vacation requests and approve/deny.
• Attend monthly staff meetings, management meetings, case conference meetings and other meetings and trainings as appropriate.
• Responsible for ongoing staff training as PCA program processes are improved or updated.
• Periodically observe staff in the community and offer feedback.
• Provide daily support and offer feedback to the Evaluation Department staff
• Initiate any Critical Incident reports as appropriate.
• Communication with consumers regarding questions related to MassHealth Evaluation.
• Complete MassHealth Evaluation for PCA Program, re-evaluations or adjustments as needed.
• Provide coaching to staff and document efforts as needed.
• Review tracking reports to monitor timelines, monthly reviews of evaluations completed by each staff: # completed, error rate, and MassHealth inquiries. Follow up with staff regarding timeliness of adjustments and re-evaluations as necessary.
• Oversee initials and re-evaluations assignment.
• Review initial evaluations for completeness .
• Review all re-evaluations with reduced hours indicating hours changes greater than 20% plus or minus, and follow up as needed.
• Terminate consumers found ineligible at the initial evaluation and ensure documented progress note in database.
• Review and appropriately process consumers found ineligible at the initial evaluation or re-evaluations/adjustments and document in database.
• Assist with Forward and/or Follow up on MassHealth inquiries to with staff and respond when appropriate.
• Frequently interact with MassHealth to escalate quality of care issues and to facilitate appropriate problem solutions.
• Provide support and updates to RN Consultants.
• Communicate regularly with 2 administrative staff regarding scheduling initial evaluations to follow up on status of initials, re-evaluations and administrative projects.
• Provide coverage and support for PCA Program staff in absence of other PCM Supervisors.
• Participatein MassHealth meetings as needed.

Competencies

• Outstanding customer service.

• Current RN licensure.

• Prefer at least 5 years'experience doing clinical assessments, PCA Evaluations or Re-evaluations or working directly in the PCA program.

• Must be computer literate with ability to use spreadsheets and database for information management and oversight.

• Prefer previous supervisor experience.

Work Environment

• This job operates in a professional office and home environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, electronic filing system.

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job

• While performing the duties of this job, the employee is regularly required to communicate. The employee is frequently required to sit; stand; walk; use hands to finger, handle or feel; reach with hands and arms; and carry laptopcomputer and/or documents.

Travel

• Occasional travel is required for this position. Must have a valid driver'slicense and reliable transportation.

Other Duties

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activitiesmay change at any timewith or without notice.