Accessibility Solutions Specialist (Org Wide) (Home-Based) at Lakeland Care Incorporated

Fond Du Lac, Wisconsin, United States -

Full Time

Start Date

Immediate

Expiry Date

28 Aug, 26

Salary

0.0

Posted On

30 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Functional Assessment, Utilization Review, Care Planning, DME/DMS Knowledge, Medicare and Medicaid Reimbursement, Interdisciplinary Team Collaboration, Microsoft Office, Clinical Assessment, Case Management, Patient Education, Resource Allocation, Critical Thinking

Industry

Hospitals and Health Care

Description

Description We're growing - join our award winning culture as we serve members in your area! Under the general supervision of the Service Utilization Supervisor, the Accessibility Solutions Specialist supports interdisciplinary team (IDT) staff in assessing and determining appropriate utilization of adaptive and durable medical equipment and disposable medical supplies. This position is responsible to support IDT staff in promoting the overall well-being of the members LCI serves by providing high quality, cost-effective, person-centered, outcome-based care in accordance with LCI policy and procedures, and Department of Health Services (DHS) Family Care contract requirements. Essential Competencies: Ensure adherence to DHS contract requirements through internal policy, procedure and best practice development and implementation. Participate in utilization review and quality improvement processes. Coordinate payor requirements (Private Insurance, Medicare, Medicaid/Family Care). Timely and accurately complete documentation. Conduct a functional assessment of the member including the environment to identify risks and opportunities to improve and/or maintain health, safety, and independence in the most integrated setting. Gather and evaluate information that leads to sound, smart decisions. Utilize subject matter expertise and evidenced-based practice guidelines to impact the care plan and identify treatment plan alternatives Educate IDT staff on Medicare and Medicaid requirements for general DME/DMS. Works in partnership with others to develop and maintain cost-effective service authorization practices, implement quality improvement initiatives, conduct utilization review, and review the effectiveness of service coordination policies and procedures to ensure effective delivery of the Family Care benefit. Respect other opinions and concerns and value diversity in thought and action. Exhibit maturity, resiliency and sound judgement when dealing with organizational challenges. Demonstrate emotions appropriate to the situation and continue to perform steadily and effectively. Respond constructively to emotional situations, high pressure, and conflict. Liaison with community and provider stakeholders as needed to develop and strengthen our service delivery outcomes and sustainability, simultaneously. Engage the IDT staff, the member, his/her support system, and the primary care provider or specialist in the decision-making and care planning process. Collaborate with the selected vendor to procure the most effective and cost-effective DME or adaptive aid service/support based on the member’s needs. Review the member record and evaluate the impact of this information on the assessment and care planning process specific to the member’s potential need for specialty equipment and/or home/vehicle modifications. Uphold the guiding principles of the organization, lead by example, and hold each other and all staff accountable. Produce results through timely decision making and strategic implementation and evaluation of programs and policies. Requirements Associate degree in Occupational or Physical Therapy, Kinesiology, Nursing, Rehabilitation Science, a related field, or equivalent combination of education and experience (includes knowledge, skills, and abilities). Minimum of two (2) years clinical experience in acute or long term care setting, Rehabilitation setting, home health care, or other relevant environment. Demonstrates proficiency in applying the Family Care principles and Resource Allocation Decision process to practice. Knowledge of Medicare and Medicaid reimbursement related to DME/DMS highly desired. Excellent verbal and written communication; communicates with internal and external partners respectfully and effectively. Proficiency in use of Microsoft Office (Excel, PowerPoint, and Word). Attention to detail, adaptable and the ability to critically think in a fast-paced environment. Ability to access members’ homes which are not required to comply with the ADA regulations. Ability to lift up to 25 lbs. Current driver’s license, acceptable driving record and proof of adequate insurance required. ------------------------------------------------------------------------------------------------- Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities. Currently we serve members in 22 counties and have 11 offices throughout the Central to North East region of Wisconsin. Our Mission Empowering individuals. Strengthening communities. Inspiring futures. Our Vision To create a world we all want to live in. Our Core Values Kindness – We believe kindness is always possible and that no compassionate act is ever wasted. Inclusion – We believe that open hearts and open minds are the only path to a brighter future. Trust – We believe that honesty is still in style and that promises still have power. We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.

Responsibilities

The specialist supports interdisciplinary teams in assessing and determining the appropriate use of adaptive and durable medical equipment for members. They ensure adherence to DHS contract requirements while providing cost-effective, person-centered care and conducting functional assessments.