Section 240.1430  Care Coordinator Staff Positions, Qualifications and Responsibilities

a)         A CCU shall have specified staff to carry out the following functions:

1)         care coordination; and

2)         supervision of care coordinators.

b)         Care coordination supervisor qualifications shall be as specified in 89 Ill. Adm. Code 220.605(a)(2).

c)         Care coordination qualifications shall be as specified in 89 Ill. Adm. Code 220.605(b)(2).

d)         Care coordinator activities and responsibilities shall, at a minimum, include:

1)         administration of the DON;

2)         development of a Participant Agreement – Person-Centered Plan of Care;

3)         performance and/or approval of Choices for Care screening;

4)         performance of HFS Level I Screen;

5)         authorization of CCP services; and

6)         attendance at appeal hearings.

e)         Required activities that may be performed by a care coordinator or other CCU staff include:

1)         screening of inquiries;

2)         arranging for service implementation in accordance with each specific Participant Agreement – Person-Centered Plan of Care;

3)         completing required billing activities with the Department;

4)         reviewing and correcting required billing activities with the Department;

5)         assisting providers with Vendor Request for Payment (VRFP) rejects;

6)         timely provision of documents requested by the Department for participant appeals or other Departmental matters;

7)         implementing case transfers; and

8)         assisting with completion and submission of participant Medicaid applications.

(Source:  Amended at 48 Ill. Reg. 11053, effective July 16, 2024)