Case Managers' Role
But all the federal assurances and rules established by CMS and your state would mean nothing without quality case management. Ultimately, quality services and supports begin with the interaction between a participant and a case manager; quality depends on your ability to implement the safeguards contained in the assurances.
The actual role of a case manager may vary across states, but most case managers perform the following core functions in assuring the quality of an HCBS waiver:
- Assessment: The foundation of your work is an accurate evaluation of a participant’s strengths, needs, preferences, supports and desired outcomes.
- Service plan development: You work with participants to design a service plan that enables them to meet their goals.
- Referral: You provide information to help participants choose qualified providers and make arrangements to assure providers follow the service plan.
- Monitoring: You make sure participants get authorized services and that services meet individual needs and goals.
- Remediation: You resolve problems when something goes wrong as well as anticipate the potential for problems.
