Skills Trainer-PCM

Sign on bonus $3,500 for Full Time (30-40 hours) and $1,750 for Part Time (20-29 hours) positions. The bonus will be paid out in two increments!

Under the direction of the Personal Care Management Director, the Skills Trainer is responsible for the Intake and Orientation visits for the consumers, in accordance with Mass Health PCM contract and regulations. This position assists Mass Health Consumers, prospective surrogates and Community Case Management in developing the skills and acquiring resources necessary for the Consumer/Surrogate to successfully self-manage their PCA program in the following areas: employment and management of PCA workers, personal health care, emergency needs and fulfilling responsibilities related to the Fiscal Intermediary. This position involves time sensitive practices, strict adherence to documentation and recording requirements, and tracking of consumer’s Prior Authorization. This position works closely with all members of the PCM team.

1. Provide skills training responsibilities in person to a caseload of consumers who are beyond their first year of prior authorization and progress notes in database to reflect all efforts.

2. Review and adhere to skills training requirements based on the Mass Health PCM Contract and Mass Health regulations.(i.e., update service agreement, management assessment review, PA documents, required supportive documentation, non-covered services, community resources, recruitment of PCA’s.

3. Establish a functional and organized home-based filing system and tracking system in order to provide effective and efficient skills training needs while tracking supportive documentation in order to meet Mass Health 21 day submission prior to the consumer’s PA expiration date.

4. Follow up on all consumer phone calls received within two business days of receipt and document in consumer Functional skills training as Log a Call in database and consumer file.

5. Insure that all consumer records are current and up to date with all necessary documents per Mass Health requirements.

6. Monitor consumer-billing issues and provide skills training needs consistent with Mass Health regulations in the event that an overbilling letter is generated from the FI. Document all actions and resolution in consumer file. In the event that a face to face skills training review is necessary on a case-by-case basis, the PCM Director will be notified and Face-to-Face Skills Trainer will be assigned.

7. Provide skills training needs in the event that there is a payroll related issue on a case-by-case scenario and document in database in functional skills training progress notes and in consumer file.

8. Review “Adjustment Request “ procedure with consumers in the event that there are significant changes in consumer’s medical status and/or living situation. Communicate specific case-by-case issues to the PCM Director for proposed adjustment requests.

9. Review all prior authorizations over the phone and assist consumers with any correspondence received from Mass Health and document resolution in database and consumer file. Review and research eligibility status with consumer/surrogate in the event that the consumer’s Mass Health coverage has changed from either “Standard” or “Commonhealth”.

10. Problem solve day-to-day consumer issues and other duties as needed.

Education/Experience/Training: five or more years’ experience with PCA services and individuals with various disabilities. Ongoing trainings as offered. Must have an acceptable inquiry responses as required for: criminal offender record (CORI), Sexual Offender Record (SORI) and Driving History

The Arc of the South Shore strongly encourages all employees to be vaccinated for COVID-19. We follow all State and CDC COVID-19 safety guidelines.

The Arc of the South Shore is an equal opportunity employer