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Entitlements Case Manager 8

Community Wellness Outpatient Mental Health Center
Baltimore, USA
Manager · 2+ years experience
Onsite
Discovered 1 weeks ago
Communication

Full Job Posting

Key Responsibilities

  • Step in as backup coverage upon CWPRP request.
  • Meet documentation timelines and quality requirements.
  • Support audit readiness and QI efforts; uphold HIPAA and confidentiality.
  • Collaborate with CWPRP staff and external partners as needed.
  • Deliverables
  • Signed documentation (notes, assessments, IRP/ITRP updates, coordination records) within 24–48 hours of service.
  • Accurate coding (W1760, W1761, H0002) and complete billing support artifacts.
  • Brief coverage log/report for the assignment period, if requested.

Qualifications

  • Education: Bachelor’s in psych/social work/counseling/nursing or related (Master’s preferred).
  • Licensure/Certification (one or more): LCADC, LGADC, CAC-AD, CSCAD, ADT, LCPC, LGPC, LCSW-C, LCSW, LMSW, LBSW, LCMFT, LGMFT, Licensed Psychologist, Registered Psychology Associate, CRNP-PMH, APRN-PMH, CNS-PMH, or eligible student intern.
  • Experience: 2+ years in behavioral health/PRP/Health Home/rehab/community services.
  • Skills: ICANotes/CRISP familiarity; strong documentation; trauma-informed, culturally responsive practice; knowledge of COMAR/Medicaid.
  • Reporting & Coordination
  • Receives assignments/coordination from the CWPRP Operations Manager or designee (coordination does not create an employment relationship).
  • Working Conditions
  • Work may be on-site, community-based, or remote depending on assignment; occasional travel possible.
  • Contractor supplies and secures own equipment; maintains HIPAA compliance at all times.
  • Insurance Requirements (Contractor-Carried)
  • Contractor must maintain, at Contractor’s expense, the following coverages and furnish Certificates of Insurance (COIs) before activation and upon renewal:
  • Professional Liability (Malpractice): Minimum $1,000,000 per claim / $3,000,000 aggregate (claims-made acceptable). If claims-made, provide 2-year tail coverage post-engagement or continuous prior-acts coverage.
  • General Liability: Minimum $1,000,000 per occurrence / $2,000,000 aggregate.
  • Automobile Liability: If driving on assignment, at least $300,000 combined single limit (or state minimums if higher).
  • Cyber / Privacy Liability: Recommended $250,000+ for PHI/PII incidents (may be required for remote/EHR access).
  • Workers’ Compensation/Disability: As required by law for Contractor’s own business.
  • COI Requirements:
  • Certificate Holder: Community Wellness Psychiatric Rehabilitation Program (CWPRP).
  • Additional Insured: CWPRP on GL (and Auto, if applicable) with Primary & Non-Contributory wording and Waiver of Subrogation where available.
  • Notice of Cancellation: 30 days’ notice requested.
  • CWPRP may suspend assignments for lapsed insurance.
  • Invoicing & Payment Requirements
  • A) Eligibility to Invoice
  • Invoice only for authorized assignments actually performed and fully documented in ICANotes (signed/locked).
  • No billing for admin time, travel, or training unless pre-authorized in writing.
  • B) Invoice Contents (required)
  • Include a clean, legible invoice with:
  • Contractor legal name/entity, remit address, email/phone, and EIN/SSN (W-9 on file).
  • Unique invoice # and invoice date.
  • Service dates and total hours/units by billing code (W1760, W1761, H0002).
  • Hourly rate and line-item extensions; total amount due.
  • Assignment/location (site or telehealth), and client identifiers using non-PHI internal IDs (no names/DOB/SSN).
  • Reference to ICANotes encounter IDs or attached time/units export (if requested).
  • Attestation: “I attest services were rendered as authorized, documented in ICANotes, and comply with CWPRP standards and applicable regulations.”
  • C) Submission & Timing
  • Cadence: Weekly or bi-weekly, as directed during onboarding (submit within 5 business days after period end).
  • Where to send: Submit per onboarding instructions to CWPRP Accounts Payable (cc: Operations Manager).
  • Terms: Standard Net 30 from receipt of a complete, undisputed invoice. (CWPRP may specify Net 15/20 in writing.)
  • D) Disputes, Corrections, and Holds
  • CWPRP will notify Contractor of any invoice/documentation issues; Contractor must correct within 5 business days (or sooner if required).
  • Non-conforming or undocumented services will not be paid until corrected and verified.
  • Duplicate billing, unsupported units, or late documentation may be reduced/denied.
  • E) Reimbursable Expenses (rare)
  • Not standard. Only reimbursed if pre-approved in writing with receipts; mileage or per-diem only if expressly authorized (otherwise deemed included in rate).
  • F) Payment Method
  • ACH preferred (provide banking details); check available if set up is not possible.
  • Compliance & Security (Summary)
  • Adhere to COMAR 10.21.21.10 (PRS), COMAR 10.09.33.06 & MDH Health Home Manual (HHCM), Medicaid/CARF, HIPAA, and CWPRP policies.
  • Sign CWPRP Business Associate Agreement (BAA) before system access.
  • Use encrypted devices; no PHI on unencrypted storage or unsecured networks; return/destroy CWPRP data at engagement end.
  • Contractor Acknowledgment
  • This SOW defines the services, deliverables, insurance, and invoicing standards for the 1099 Backup PRS/HHCM role at CWPRP. Engagements are as-needed and contingent on CWPRP requests.
  • Qualifications & Licensing
  • Must hold a valid Maryland license or certification:
  • LCADC, LGADC, CAC-AD, CSCAD, ADT, LCPC, LGPC, LCSW-C, LCSW, LMSW, LBSW, LCMFT, LGMFT, Psychologist, Registered Psychology Associate, CRNP-PMH, APRN-PMH, CNS-PMH, or eligible student intern in one of these disciplines.
  • Compensation, Invoicing & Payment
  • Paid per service rendered (session, group, or client contact).
  • Submit weekly invoices (Sunday–Saturday) by Saturday midnight for the next check run.
  • Late invoices may be processed in the next cycle.
  • Contractors are responsible for taxes, insurance, and licensing costs.
  • Independent Contractor Status
  • Contractors have autonomy over how services are provided within program standards.
  • Not eligible for employee benefits (health insurance, paid leave, unemployment, etc.).
  • Must maintain professional liability insurance and provide proof upon request.
  • Proposal Submission Process
  • Proposals are accepted on a rolling basis. Submit responses to all required fields below.
  • Include:
  • Contractor Information – Full name/business name, contact details, and license (if applicable).
  • Qualifications & Licensing – Maryland license per above list.
  • Experience & Approach – Relevant experience and documentation proficiency (ICANotes preferred).
  • Rate & Compensation – Proposed per-service rate and related costs.
  • Availability – Days/times available for in-person sessions.
  • Proposal Evaluation
  • Proposals are scored (total 100 points):
  • Qualifications & Licensure – 30%
  • Relevant Experience – 25%
  • Rate Competitiveness – 20%
  • Availability & Alignment – 15%
  • Completeness & Professionalism – 10%
  • Top candidates will be contacted for discussion or contract negotiation.
  • Questions: Contact the Contract Administrator at (667) 400-6206 EXT 10.
  • OPTION 2: W-2 EMPLOYMENT VERSION
  • (For those seeking a traditional employment arrangement)
  • DISCLOSURE - MULTI-EMPLOYER ROLE:
  • This W-2 fee-for-service Co-Occurring Disorder Counselor position includes responsibilities that span across the following three organizations, all under shared leadership:
  • FOCUS #1 Lighthouse Behavioral Health Center, LLC
  • FOCUS #2 Community Wellness Outpatient Mental Health Center, LLC
  • FOCUS #3 Community Wellness Psychiatric Rehabilitation Program
  • You will maintain separate W-2 employment relationships with each organization and will receive individual payroll compensation from each entity based on the time worked and services provided for their respective programs. This means you will be an official employee of all two companies, with service documents, responsibilities, and compliance obligations tracked separately for each.
  • Though the employee is paid on a fee for service basis and not an hourly basis, the services will require approximately 40 hours per week in to render assigned services as scheduled over 5 days, with an estimated one-half of the services rendered allocated to each organization. While day-to-day supervision and scheduling will be coordinated centrally to support integrated care, each employer will manage its own onboarding, HR, and compliance processes in accordance with applicable laws and organizational policies.
  • DIVISION: Operations
  • UNIT: N/A
  • CLASSIFICATION: Part-Time (W2). Fee-for-service.
  • Lighthouse Behavioral Health Center, LLC (LBHC): Part-time, W-2 employee – Approximately 20 hours per week (50% of total weekly hours)
  • Community Wellness Outpatient Mental Health Center, LLC (CWOMHC): Part-time, W-2 employee – Approximately 20 hours per week (50% of total weekly hours)
  • ACCOUNTABLE TO: Operations Manager 2

Experience

  • Minimum 2 years of experience in behavioral health, psychiatric rehabilitation, Health Home coordination, or community-based case management.
  • Knowledge, Skills, and Abilities
  • Familiarity with ICANotes and CRISP or other EHR/HIE platforms.
  • Strong documentation and organizational skills.
  • Ability to work with diverse and vulnerable populations.
  • Trauma-informed and culturally responsive practice.
  • Knowledge of Medicaid, COMAR, and CARF standards.
  • LEVEL OF EDUCATION / TRAINING / QUALIFICATIONS:
  • Education:
  • Bachelor’s degree in psychology, social work, counseling, nursing, or a related field required.
  • Master’s degree preferred.
  • Licensure/Certification:
  • To be eligible for this contract, the contractor must hold valid Maryland licensure, including one of the following:
  • LCADC, LGADC, CAC-AD, CSCAD, ADT
  • LCPC, LGPC
  • LCSW-C, LCSW, LMSW, LBSW
  • LCMFT, LGMFT
  • Licensed Psychologist, Registered Psychology Associate
  • CRNP-PMH, APRN-PMH, CNS-PMH
  • Student intern in an eligible discipline may be considered.

Preferred Qualifications

  • Education: Bachelor’s in psych/social work/counseling/nursing or related (Master’s preferred).
  • ACH preferred (provide banking details); check available if set up is not possible.
  • Experience & Approach – Relevant experience and documentation proficiency (ICANotes preferred).

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