Exception Template: 
HCBS Incident Coordinator 
WD Job Code: 112501 
 
Position Purpose: 
This role will be responsible for the development, implementation, resolution and oversight of waiver incident reporting at member level and organizational level. The primary functions will include waiver incident reporting education, incident reporting, incident investigation, incident processing and closure. Position ensures Buckeye's compliance with our Three-Way and Provider Contract along with the Ohio Administrative Code and CMS regulations delegated to Buckeye through the MyCare Ohio Waiver administered through the MMP in Ohio and other required Incident Reporting in Medical Management as outlined our MCO/MCOP Provider Agreements. The MyCare Ohio Waiver is a 1915 c waiver approved by CMS for Ohio. 
 
For PHW ONLY: This position ensures PHW's compliance with 55 Pa. Code § 52and CMS regulations as defined and delegated in C.F.R. § 447.26, APS Act 70 of 2010, 35 P.S. §§ 10210.101 -10210.704, OAPSA 35 P.S. §§10225_101 -10225.5102 and 6 Pa. Code, Chapter 15, and Community HealthChoices Agreement, Exhibit W(1) Critical Incident Reporting and Management and Provider Preventable Conditions/Preventable Serious Adverse Events Reporting. The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in §1915(c) of the Social Security 
Act. 
 
 
Education/Experience: 
Degree and or certificate/licensure required in a field of Nursing, Social Work and/or Counseling. Two years of experience required. Must have knowledge of waiver and incident reporting. 
 
Licensure or Certifications: Clinical licensure/certification is preferred: LPN, SWA, CHW, LSW or LPC. Clinical experience in lieu of licensure will be considered. 
 
PHW ONLY: Clinical licensure is preferred but is not required. Clinical experience in lieu of licensure will be considered. Must have at least two years of experience and knowledge of waiver.

Contract - Claims/Appeals

$28 - $29/hr

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