Operations & Care Coordinator

Job Description

Job Description

Benefits:

• Bonus based on performance
• Competitive salary
• Paid time off
• Training & development

Company background: Carefully Caring Homecare in Philadelphia is dedicated to enhancing the quality of life for individuals with developmental disabilities, autism, and physical disabilities. Through compassionate, person-centered non-medical care, we empower individuals to live with independence, and community engagement. We work with those covered under Medicaid Waiver programs ODP and OLTL and some Private Pay clients. Under ODP Office of Developmental Programs we serve individuals with developmental disabilities and autism and under OLTL Office of Long-Term Living we serve seniors and adults with physical disabilities. Our team currently includes a small group of office professionals and direct care staff to deliver exceptional care.

Role Summary: Manage care staff, client care, quality assurance, billing, and marketing. This is a hands-on, in-office, role without supervisory responsibility within a small agency for someone compliance and growth driven who loves creating SOPs, improving workflows, and helping a small agency become more system-based.

The Staff part of the role includes responsibilities for the care staff including for:
Managing daily schedules for Direct Support Professionals (DSPs) using, HHAeXchange,
Ensuring coverage for all clients/participants,
Fielding staff calls,
Collecting and approving weekly time cards,
Ensuring alignment between ADP (timekeeping/payroll), hours worked and HHAeXchange, in conjunction with the HR Manager,
Using HHAeXchange to identify Electronic Visit Verification (EVV) compliance issues,
Creating operational reports (scheduling gaps, EVV compliance %, staff hours, etc.).

The Client Care part of the role includes responsibilities for:
Performing the complete intake/onboarding process for all new clients/participants,
Receiving referrals, verifying eligibility, and collecting necessary documentation,
Communicating clearly with clients and their families about available services,
Implementing and monitoring Individualized Support Plans,
Acting as the bridge between clients, families, caregivers, and the CCHC team to promote a seamless onboarding and service experience,

Client care also includes QA related responsibilities for:
Implementing quality assurance policies and procedures,
Conducting audits and reviews to ensure compliance with in-home quality standards,
Perform in-home visits, phone calls, and care team meetings, to monitor client care,
Gathering and reviewing service notes,
Maintaining accurate documentation for audits, licensing, and incident reporting.

The Billing and Claims Management part of the role includes responsibilities for:
Serving as the agencys primary biller, managing all Medicaid waiver billing activities (ODP and OLTL) through NaviNet, Promise, and HHAeXchange.
Verifying all service codes, units, and authorizations before submission,
Monitoring discrepancies between scheduled hours, EVV-recorded hours, and billed hours,
Monitoring payments received from all MCOs and state systems (NaviNet, Promise),
Preparing reports on: Billed vs. paid claims, Outstanding receivables (aging reports), EVV compliance rates and Trends in billing errors or denials.

The Marketing part of the role includes responsibilities for:
Sending out emails to current and past clients and their families to develop leads,
Maintaining social media accounts on Facebook and Instagram and blogs
As time permits, attending networking events,
Performing meet and greets and visits to hospitals, doctors offices and more,

Additional other responsibilities include:
Making all aspects of our business from staffing, to training, to QA to every part process based,
Contributing to process documentation creating internal SOPs and workflow maps to scale operations,
Creating a learning culture, where we train and retrain all team members continuously,
Performing other admin functions as needed,
Occasionally, covering shifts in homes, in case of no coverage available-not frequent.

Required education & experience:
Associates or Bachelors degree in Human Services, Social Work, Nursing, or related field preferred.
Minimum 23 consecutive years of experience in client intake, program coordination, or case management within homecare, developmental disability services, or a related field.

Required skills & software:
Highly driven to implement system and process best practices, ,
Minimum 12 years of direct ODP/OLTL Medicaid Waiver billing experience using HHAeXchange, NaviNet, and Promise.
Knowledge of ODP/OLTL waiver regulations, person-centered planning, and care coordination best practices,
Knowledge of physical disabilities, developmental disabilities and/or autism.
Experience using ChatGPT in a professional setting to improve your ability to perform your role,
Proficiency in Excel, Word, and Google docs, required,
Familiarity with EVV (Electronic Visit Verification) systems and compliance reporting at the state and city level,
Compliance driven.
Strong attention to detail for reconciling hours, units, and payments,
Valid Drivers license and use of own personal vehicle.

Compensation:
Competitive salary based on experience.
Paid time off.
Incentives based on performance.
Opportunities for professional development and advancement.