CASE MANAGEMENT SERVICES PROVIDER IN WYOMING
- Fatumata Kaba
- Apr 14
- 4 min read
COORDINATING COMPREHENSIVE SUPPORTS TO ENSURE INDIVIDUALIZED, PERSON-CENTERED CARE PLANNING AND SERVICE DELIVERY
Case Management Services in Wyoming help individuals with disabilities, chronic illnesses, or long-term care needs access and coordinate the services required to live safely and independently in the community. Case managers serve as the central point of contact for participants, guiding them through the waiver system, ensuring compliance, and promoting person-centered planning. Case Management is a required service under Wyoming’s HCBS Waivers, including the Comprehensive and Supports Waivers (Developmental Disabilities Division) and the Community Choices Waiver (CCW) for seniors and physically disabled adults. Services must be delivered by certified or licensed professionals following state-defined protocols.
1. GOVERNING AGENCIES
Agency: Wyoming Department of Health – Developmental Disabilities Division (DDD) & Division of Healthcare Financing
Role: Establishes standards for case management practice, oversees service authorization, and monitors provider compliance.
Agency: Medicaid Provider Services
Role: Handles provider enrollment, billing, and reimbursement for case management services.
Agency: Public Health Nursing (PHN) & Community-Based Case Management Agencies
Role: Deliver case management under CCW and coordinate care across providers and support.
2. CASE MANAGEMENT SERVICES OVERVIEW
Case managers ensure participants receive the appropriate services and supports to meet their needs. The role involves advocacy, planning, coordination, and monitoring.
Key case management functions include:
Conducting assessments and identifying functional needs
Developing and updating the Individualized Plan of Care (IPC)
Coordinating waiver and non-waiver services
Monitoring service delivery and participant satisfaction
Assisting with provider selection and enrollment
Educating participants on rights, choices, and available supports
Responding to crises and making referrals to appropriate services
Maintaining contact with participants (monthly or quarterly, depending on waiver)
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register as a business with the Wyoming Secretary of State
Obtain a Federal EIN and Type 2 NPI
Apply for Medicaid enrollment under applicable waiver programs
Submit a Case Management Policy & Procedure Manual
Hire qualified staff who meet education and experience requirements
Staff must meet the following minimum qualifications:
Bachelor’s degree in social work, human services, nursing, or related field
At least one year of experience working with individuals with disabilities or aging populations
Complete state-mandated case management training
Pass background and abuse registry checks
4. WYOMING PROVIDER ENROLLMENT PROCESS
Step 1: Register business and obtain EIN/NPI
Step 2: Apply to become a certified case management agency through DDD or PHN
Step 3: Submit staff credentials, manual, and supporting documentation
Step 4: Enroll with Medicaid for waiver-based billing
Step 5: Complete state training and orientation for case managers
Step 6: Begin services upon participant assignment and plan authorization
5. REQUIRED DOCUMENTATION
Medicaid and waiver provider enrollment records
Case Management Policy & Procedure Manual, including:
Assessment and IPC development processes
Visit schedules and monitoring documentation
Conflict of interest policies (especially for independent providers)
Participant rights and grievance procedures
HIPAA compliance and confidentiality protocols
Safety planning and emergency response guidelines
Staff supervision and ongoing training protocols
Sample contact notes, review logs, and satisfaction surveys
Staff qualifications, background checks, and training logs
6. STAFFING REQUIREMENTS
Role: Case Manager
Requirements:
Bachelor’s degree in social work, nursing, psychology, or related field
Completion of state training (e.g., person-centered planning, HCBS policies)
Demonstrated experience working with disability or aging populations
Valid driver’s license and reliable transportation (for home visits)
All staff must complete:
HIPAA and participant confidentiality training
Abuse, neglect, and exploitation prevention
Crisis response and documentation standards
Ongoing continuing education and policy refreshers
7. MEDICAID PROGRAMS THAT COVER CASE MANAGEMENT SERVICES
Comprehensive Waiver (I/DD): Provides ongoing case management as a required service
Supports Waiver (I/DD): Also includes required case management tied to IPC updates
Community Choices Waiver (CCW): Case management is provided by Public Health Nursing or contracted agencies
Katie Beckett & EPSDT Programs (Under 21): May include coordination supports when medically necessary
Note: Case managers cannot provide direct services to avoid conflicts of interest. Monitoring visits and documentation must occur as scheduled, with all contact notes maintained for audit purposes.
8. TIMELINE TO LAUNCH
Phase: Business Registration & Manual Development
Timeline: 2–3 weeks
Phase: Staff Hiring & Training
Timeline: 30–60 days
Phase: DDD/CCW Certification & Medicaid Enrollment
Timeline: 1–2 months
Phase: Begin Case Assignments & Billing
Timeline: Once certification is approved and participants are assigned
9. CONTACT INFORMATION
Wyoming Medicaid Provider Services
Developmental Disabilities Division (DDD)
Community Choices Waiver Info
Wyoming Secretary of State – Business Portal
Website: https://sos.wyo.gov
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — WYOMING CASE MANAGEMENT PROVIDER
WCG helps human services professionals and agencies build strong, person-centered case management programs that meet Wyoming Medicaid requirements and support whole-person care.
Scope of Work:
Medicaid and waiver enrollment for case management
Case Management Policy & Procedure Manual development
IPC templates, contact note formats, and monitoring tools
Staff credentialing logs and supervision documentation
Participant rights forms and service satisfaction checklists
Audit readiness and compliance tracking resources
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.
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