The Community First Choice (CFC) Service Representative is responsible for providing administrative and care coordination support for participants enrolled in the Community First Choice program. This position ensures timely and accurate service authorization, care plan management, quality assurance activities, and ongoing communication with participants and the Connecticut Department of Social Services (DSS). The Service Representative maintains a caseload of approximately 150–200 participants and plays an integral role in supporting participant-centered services while ensuring compliance with state program requirements.

• Enter approved annual care plans into the NOMMA system using the required prior authorization methodology for all Community First Choice (CFC) services.
• Update care plans to reflect approved changes, modifications, or service discontinuations.
• Maintain accurate participant records and documentation in accordance with Agency and DSS policies.
• Review monthly overutilization reports provided by GTI and complete Technical Assistance calls as requested by the Department of Social Services.
• Conduct quarterly telephone contacts with assigned participants to:
  • Complete quality assurance reviews.
  • Assess care plan utilization.
  • Evaluate participant satisfaction with services.
• Contact participants one month prior to their annual reassessment to:
  • Confirm current address and contact information.
  • Remind participants of the requirement to complete their annual CFC reassessment.
• Manage an assigned caseload of approximately 150–200 participants.
• Complete Critical Incident Reports when appropriate and ensure timely reporting in accordance with Agency and DSS guidelines.
• Complete follow-up activities requested by DSS or Agency supervisors.
• Initiate referrals for Support and Planning Coach services and enter related service authorizations.
• Collaborate with care managers, providers, DSS staff, and other community partners to ensure continuity of participant services.
• Maintain confidentiality of participant information and comply with all HIPAA and Agency policies.
• Perform other duties as assigned to support the Community First Choice program.
• Qualifications

• Associate's degree preferred; equivalent combination of education and relevant experience may be considered

• Experience in human services, aging services, healthcare, case management support, or a related field preferred.
• Experience working with older adults and individuals with disabilities is desirable.
• Experience with electronic databases and documentation systems preferred.
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Knowledge, Skills, and Abilities

• Strong organizational skills and attention to detail.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities and maintain a large caseload efficiently.
• Proficiency with Microsoft Office applications and electronic record systems.
• Ability to work independently while collaborating effectively within a team.
• Strong customer service and problem-solving skills.
• Knowledge of Community First Choice, Medicaid, or long-term services and supports programs is preferred.

Physical Requirements

• Ability to sit for extended periods while using a computer and telephone.
• Ability to communicate effectively with participants, providers, and staff.
• Occasional travel may be required for meetings or training.

Benefits

• Full-Time Position (37.5 hours per week)
• Competitive salary
• Comprehensive health, dental, and vision insurance
• Paid vacation, sick leave, and holidays
• Retirement plan
• Professional development and training opportunities

The Agency on Aging is an Equal Opportunity Employer and is committed to creating an inclusive workplace that values diversity and promotes equal employment opportunities for all qualified applicants.