Rehabilitation Program Specialist 2

Schedule: Full-time

Job Duties:

Works with supervisor for assignments in all the areas within the division that include Prior Authorization (PA), Nursing Tasking Inventory (NTI), State Funded Behavioral Add-on (SFBAO) and perform all duties of the RPS2.

Reviews assessments and/or requests to make determinations related to requests for PA, NTI, and SFBAO submitted by county boards of developmental disabilities (CBDDs) for initial & ongoing budget review of Medicaid Home & Community-Based Services (HCBS) Waivers.

Prepares correspondence and hearing rights to send to individuals who are denied services or found to no longer meet necessary requirements for services.

Prepares hearing summaries and supporting documentation for hearings to submit to the Bureau of State Hearings.

Reviews assessments submitted by CBDDs & develops, coordinates, monitors, reviews & evaluates Medicaid Home and Community-based Services Waiver prior authorization processes & procedures.

Reviews documentation provided by the appropriate county board of developmental disabilities (CBDD) to determine if approval criteria are met utilizing federal & state regulations.

Coordinates with department consultants for programmatic support & assistance with questionable cases or for general consultation.

Evaluates & makes recommendations of approval of prior authorization, state-funded behavior addons, and nursing waiver budgets when appropriate.

Makes recommendations for action resulting from information gathered through review process & participates in implementation of such action.

Conducts reviews in accordance with department’s polices & procedures.

Develops and write reports in accordance with office procedures.

Performs records/documentation development/maintenance functions (e.g. develops, sends & receives email & phone communications from involved parties).

Uses the appropriate DODD applications (including, but not limited to, prior authorizations, state-funded behavior addons, and nursing task inventory processes).

Collaborates with other department/division staff regarding relationship of prior authorization approval to Payment Authorization of Waiver Services (PAWS).

Provides testimony at hearings, if necessary.

Provides support to staff throughout the Department who are assigned responsibility for the administration of Medicaid processes & procedures (e.g., reviewing & revising policies & procedures related to Prior Authorization, Nursing and Waiver to inform policy analysis & development).

Monitors & evaluates systems activities of local Department of Job & Family Services (DJFS) case workers through Ohio Benefits System (OBS) (e.g., new applications, Medicaid eligibility determinations, appeals, etc.).

Advises state & local staff on correct procedures to follow to assist applicants to obtain Medicaid eligibility.

Provides technical assistance & assists in problem solving between DJFS case workers or other systems.

Implements program policy & procedures that impact waiver eligibility and Nursing.

Graduate degree in a human service area (i.e., rehabilitation counseling, special education, guidance & counseling, psychology, social work, child & family community services) as required by an accredited college or university

OR

A graduate degree that leads to licensure as a licensed professional counselor by the Ohio Counselor & Social Worker Board.

OR

Completion of graduate degree in other related vocational rehabilitation areas (e.g., rehabilitation management/administration from an accredited college or university).

OR

Completion of graduate field of study in human services area (i.e., same examples as cited previously) as required by accredited college or university AND 12 months' experience as Rehabilitation Program Specialist 1, 69731.

OR

In Ohio Department of Mental Health & Addiction Services only, licensed, certified, or registered clinical professional per OAC 5122-21-03 (E) Personnel Requirements (2).

OR

In Ohio Department of Developmental Disabilities only, 4 years' experience in private or governmental agency responsible for habilitative &/or rehabilitative programs development in developmental disabilities (i.e., working with individuals with developmental disabilities) AND a bachelor’s degree in professional human services field (e.g., psychology, education, anthropology) in accordance with provisions of 42 CFR 483.430(b)(5)(x) & interpretive guidelines issued by centers for Medicaid & Medicare services.

Job Skills: Counseling and Rehabilitation, Attention to Detail, Time Management, Confidentiality

Hourly wage will be paid at step 1, unless otherwise specified by collective bargaining agreement or rules outlined in the ORC/OAC.

The final candidate selected for the position will be required to undergo a criminal background check. Rule 5123-2-02, “Background Investigations for Employment,” outlines disqualifying offenses that will preclude an applicant from being employed by the Department of Developmental Disabilities.

No additional materials will be accepted after the closing date; in addition, you must clearly demonstrate how you meet minimum qualifications.