Who does what.

Each role below shows, at a glance, who it reports to, who it supervises, and the responsibilities it owns. Use the search bar at the top to find who is accountable for something — try a task like “medication”, “work orders”, or “payroll” and the matching roles will appear. Every role also has a Download full PDF button with the complete description.

The DSP provides hands-on daily living support, personal care, medication administration, documentation, and community access in compliance with each individual’s PCSP and HCBS requirements. DSPs are the most frequent point of contact for the individuals served and the foundation of everything the agency does.

• Direct care & person-centered support — hands-on help with bathing, dressing, toileting, eating, mobility; following the PCSP exactly
• Medication administration — Triple Check and real-time eMAR when Level I Med Aide certified
• Documentation & communication — SetWorks daily notes, eMAR, Event Reports; approved channels only
• Positive behavior support — following BSPs as written; de-escalation, not punishment
• Household upkeep — cleaning, laundry, hazards, supplies; keeping the home audit-ready
• Community inclusion — outings at least every other day, based on each person’s interests
• Emergency response — fire, tornado, medical, elopement; drills and immediate reporting
• Individual rights & HCBS compliance — protecting choice, privacy, confidentiality; mandatory reporting
• Training & development — completing certifications; pursuing the C-DSP pathway

• 18+, high school diploma/GED, valid driver’s license & insurable record
• Passes DMH background checks and drug screen
• Maintains MANDT, Tools of Choice, Level I Med Aide and other required certifications

Physical: team-lift up to 100 lbs; kneel/stoop/bend; assist a fallen person with team support; drive agency vehicles; perform MANDT interventions when required.

Systems used:

The Lead DSP provides essential evening and every-other-weekend coverage and serves as the on-site leader during critical shifts — delivering high-quality direct support while mentoring DSPs and ensuring continuity of operations. The role is expected to function as an Assistant House Manager and fill in for the House Manager when necessary, taking responsibility for supervision, documentation oversight, staff coordination, and compliance with agency policy, HCBS requirements, and Missouri DDD regulations.

Direct support & shift leadership

• Person-centered care aligned with each individual’s PCSP; hands-on support with daily living, community engagement, skill-building, and goal progress
• Acting as the on-site lead during evening shifts — coaching DSPs and ensuring a positive, rights-based environment (dignity, autonomy, privacy, inclusion)
• Communicating shift updates, concerns, and incident reports to the House Manager and Program Manager

When acting as Assistant House Manager or House Manager

• Serving as the designated supervisor in the absence of the HM or AHM; coordinating staff coverage and calling in replacements
• Overseeing daily routines, medication administration records (MARs), and house logs; ensuring documentation is accurate, complete, and submitted on time
• Monitoring individual budgets, fund ledgers, and proper use of personal spending money
• Maintaining a clean, safe, licensing-compliant home; communicating with families, guardians, and Support Coordinators
• Leading by example with respectful, trauma-informed interactions with individuals and staff

• Current DSP or equivalent experience required; prior leadership, mentoring, or supervisory experience in residential settings strongly preferred
• Solid understanding of the HCBS Settings Rule and Missouri DDD rights and policies
• Strong organizational, decision-making, and communication skills; reliable and able to act with integrity under pressure
• Knowledge of MARs, PCSPs, incident reporting, and behavior support documentation preferred

Physical: hands-on direct-care role — team-lift, assist with transfers and personal care, and respond physically in emergencies as trained (consistent with DSP/AHM demands).

Systems used:

The AHM is a front-line working supervisor and role model who bridges direct care with on-shift supervisory responsibility. The role maintains household systems, holds DSPs to standard, and ensures issues are documented, tracked, and escalated — a leadership-pipeline step toward House Manager.

• On-shift supervision & standards — holding DSPs to conduct, procedures, and house routines with real-time coaching
• DSP training & onboarding — shared with the House Manager; ensuring competency before independent work
• Household systems — menus, grocery shopping to the approved menu, and keeping supplies stocked
• Medication oversight (on shift) — ensuring certified staff administer, Triple Check, real-time eMAR
• Direct care — daily living support, personal care, and community access
• Monday.com & documentation — submitting work orders, completing tasks, and timely SetWorks docs
• Funds & mileage support — assisting with grocery/EBT/personal spending as directed; tracking mileage
• Emergencies & scheduling support — drills, coverage, and ISL Management On-Call

• High school diploma/GED; completion of the C-DSP Program; min. 1 year supporting individuals with developmental disabilities (HCBS)
• Valid driver’s license & insurable record; passes DMH background checks
• Maintains MANDT, Tools of Choice, Level I Med Aide

Physical: lift/transfer/assist individuals (100+ lbs with assistance); bend, stoop, squat, reach; perform MANDT interventions and de-escalation as trained.

Systems used:

The House Manager is a front-line leader and role model responsible for the daily operation, safety, regulatory compliance, and stability of an assigned ISL home. The role bridges direct-care delivery with operational leadership, keeping the home L&C audit-ready every day. What a House Manager allows or ignores becomes the standard for the home.

• Direct care — 3 days/week of hands-on support, setting the standard for the home
• L&C readiness — keeping the home audit-ready, rights respected, equipment functional, daily
• Staff supervision & coaching — supervising the AHM and DSPs; training and onboarding new staff
• Medication oversight — certified administration, Triple Check, eMAR monitoring, Nursing coordination
• Documentation & records — accurate, current binders and electronic records; reviewing DSP docs
• Emergency drills, scheduling & on-call — running drills, coverage, ISL Management On-Call
• Medical care coordination — annual appointments, immunizations, referrals; nothing lapses
• Budget, funds & mileage — grocery/household funds, EBT, receipts; tracking monthly mileage
• Work orders & recognition — Monday.com work orders; WorkTango recognition 4×/month
• Household systems & community inclusion — menus, supplies, inventory; outings every other day

• 18+, high school diploma/GED, valid driver’s license, passes background check
• Min. 2 years supporting individuals with developmental disabilities (supervisory experience preferred)
• Maintains MANDT, Tools of Choice, Level I Med Aide; uses a computer/tablet independently

Physical: team-lift up to 100 lbs; kneel/stoop/bend; assist a fallen person with team support; drive agency vehicles; perform MANDT interventions when required.

Systems used:

The RPM provides comprehensive oversight of three ISL homes, serving as primary operational leader, regulatory liaison, and quality resource. The RPM keeps each home compliant with Missouri DMH, HCBS, and agency policy, coaches House Manager teams, and is the primary point of contact for DMH, guardians, and external stakeholders.

• PCSP coordination & DMH liaison — PCSP meetings, renewals 60 days out, intake/discharge, risk assessments
• SetWorks records & data — accurate profiles, folder naming, document uploads, record reviews
• ISL operational oversight — unannounced visits, daily L&C readiness, HCBS compliance
• House Manager supervision — weekly 1:1s, coaching, training materials, WorkTango 4×/month
• Scheduling & staffing — WhenToWork publishing, call-offs, shift-trade rules, open-shift incentives
• Medical, benefits & nursing coordination — appointments, nursing delegations, EBT/Medicaid/SSI active
• Incident reporting — Event Reports into CIMOR within one business day; KCRO notification
• HCBS rights & due process — advocating for the individual; following due process for restrictions
• Reviews & reporting — Monthly ISL Reviews by the 15th; 6-month individual feedback meetings

• Min. 3 years direct HCBS experience supporting individuals with intellectual/developmental disabilities
• Demonstrated supervision, person-centered care, and HCBS regulatory knowledge
• Valid driver’s license & background check; MANDT, Tools of Choice, Level I Med Aide

Physical: assist with transfers/personal care and respond to emergencies; computer work for extended periods; drive between homes and travel up to 4 hours one-way.

Systems used:

The DRO is the operational center of gravity for residential services — responsible for day-to-day coordination, escalation management, and cross-department follow-through. The role builds the systems, staffing patterns, budgets, and accountability structures that keep residential services stable and compliant, resolving issues at the right level and developing RPMs. Second in line for the Executive Director.

• Residential scheduling & coverage — building the WhenToWork schedule and managing call-offs/coverage gaps
• RPM supervision — check-ins, performance review, escalation judgment, preventing role creep
• Department coordination & escalation — primary escalation point; classifying and routing issues
• Quality assurance oversight — supervising the QAP; assigning and tracking corrective actions
• Staffing patterns & budgets — HCBS Waiver staffing patterns and ISL budgets submitted 90+ days out
• Training remediation routing — receiving referrals via Monday.com and tracking to completion
• Administrator On-Call — system-wide oversight; publishing the quarterly rotation
• Systems, retention & succession — process improvement, workforce stability, RPM development

• Min. 5 years direct HCBS experience with progressive operations/supervision/compliance responsibility
• Bachelor’s degree preferred (or 7+ years HCBS); knowledge of HCBS models, staffing, and regulatory compliance
• Proven ability to make complex operational decisions and supervise managers

Physical: primarily office-based with regular travel to homes; evening/weekend on-site presence and phone availability during on-call.

Systems used:

The RBT delivers hands-on behavior services under BCBA supervision, carrying out Behavior Support Plans (BSPs) exactly as written. The role supports skill acquisition, collects behavior data, and helps caregivers implement written strategies in ISL and community settings — staying strictly within the BACB RBT scope and ethics code.

Updated June 24, 2026 — see the Update History on the last page of the PDF.

• Direct service delivery — implementing BSP strategies as written; teaching replacement behaviors and skills
• Behavior data collection — recording data as defined in the BSP
• Same-day documentation — accurate session notes for all billable services in SetWorks
• Caregiver coaching (implementation only) — coaching caregivers on written plans, never clinical interpretation
• Crisis & de-escalation — MANDT-approved interventions within the BSP and scope of practice
• Ethics & certification — RBT Ethics Code (2.0) compliance; 12 PDUs per 2-year cycle; 5% monthly supervision

• 18+, high school diploma/GED; completed RBT training course and passed the RBT exam
• Active RBT certification in good standing with the BACB; ethics & supervision compliance
• Criminal background & abuse-registry checks; 12 PDUs per two-year recertification cycle
• Valid driver's license and current auto insurance (provide a copy to HR at hire and at each renewal)

Training cost: Abilities pays your hourly wage for all required training and covers the full cost of RBT certification ($951 total) up front. If you leave within your first 12 months (resignation or termination for cause), those training and certification costs may be recouped via payroll deduction.

Physical: safely respond to crisis and execute MANDT interventions/restraints; team-lift up to 100 lbs; walk/run/kneel/stoop; drive between sites.

Systems used:

The Lead RBT ensures behavior services are scheduled, documented, and implemented correctly and ethically across ISLs, while carrying a direct caseload. The role manages behavior data systems, the Abilibucks token economy, the shared RBT office, and DBT skills coaching — all under the clinical authority of the supervising BCBA.

• Scheduling & coverage — scheduling all RBT sessions in WhenToWork; approving trades and time-off
• Direct service & documentation — a caseload with same-day notes to the RBT standard
• Behavior data management — entering RBT data into Google Sheets for audit-ready retention
• Abilibucks token economy — store inventory, purchasing within budget, pricing, and tracking
• DBT skills coaching — referred coaching with signed consent submitted to HR
• Office & meetings — managing the shared RBT space; minutes to Google Drive; coaching note quality

• High school diploma/GED; active RBT certification in good standing; passed RBT exam
• Min. 1 year of RBT experience; ethics & supervision compliance with the BACB
• Background & abuse-registry checks; 12 PDUs per two-year recertification cycle

Physical: safely respond to crisis and execute MANDT interventions; team-lift up to 100 lbs; sit/stand for sessions and office work; drive between sites.

Systems used:

The Certified MANDT Instructor delivers, manages, and documents MANDT training — conducting initial certification, recertification, and quarterly hands-on refreshers in safe, trauma-informed crisis prevention and de-escalation. The role tracks training records and certificates and carries significant safety and compliance responsibility, but no supervisory authority.

• MANDT training delivery — initial certification and recertification per the approved curriculum
• Quarterly refreshers — hands-on physical-hold refreshers at every home where MANDT is used
• Training records — recording attendance, confirming completion, submitting certificates to HR
• Participant oversight & safety — verifying eligibility, monitoring competency, recommending retraining
• Instructor certification — maintaining active instructor status and the online MANDT profile
• Mandated reporting — recognizing and immediately reporting abuse, neglect, or exploitation

• 18+, high school diploma/GED; active Certified MANDT Instructor certification in good standing
• Able to meet/maintain instructor recertification; passes background check
• Reads/writes/communicates clearly in English; follows mandated-reporting laws

Physical: kneel/stoop/bend/reach and safely demonstrate approved physical techniques; stand for extended periods; drive as required.

Systems used:

The Behavior Services Director is the Board Certified Behavior Analyst (BCBA) responsible for assessment, design, implementation, supervision, and oversight of all behavior-analytic services. The role owns FBAs, BSPs, RBT clinical supervision, HCBS behavior service authorization, and training — ensuring services are ethical, evidence-based, rights-respecting, and compliant with the BACB, Missouri DMH, and HCBS Waiver, using a tiered, least-restrictive model.

• Functional Behavior Assessments — comprehensive, evidence-based FBAs identifying function and antecedents
• Behavior Support Plans — writing plain-language, rights-respecting BSPs aligned to PCSPs in SetWorks
• HCBS authorization & budget — determining service codes/units and submitting authorization requests to DMH
• RBT clinical supervision — documented direct/indirect supervision; delegating to the Lead RBT
• Documentation & service notes — same-day notes within authorized units; HCBS/DMH compliance
• Training & tiered support — training DSPs/ISL Management on BSPs; prioritizing prevention and least-restrictive supports
• Department leadership — weekly RBT meetings, hiring interviews, RBT conduct accountability

• Bachelor’s plus a graduate degree in behavior analysis or related field
• Active BCBA certification and Missouri behavior analyst license; individual NPI registered in Missouri
• All required CEUs maintained (a condition of employment)

Physical: not specified in the job description.

Systems used:

The Payroll Administrator owns the complete, end-to-end execution of payroll, ensuring all wages, premiums, deductions, reimbursements, taxable benefits, and bonuses are processed accurately, on time, and strictly per written policy. The role pulls and reconciles data from SetWorks, WhenToWork, and BambooHR and maintains audit-ready records — it executes payroll only; it does not approve, determine eligibility, or interpret policy.

• Source data validation — SetWorks Activity Records as the definitive source of payable hours vs. WhenToWork
• Pay calculations — pay-period, shift-split, overtime, sleep-shift, comped-weekend, and holiday premium rules
• PTO processing — adding approved PTO, deducting for call-ins, reflecting usage on stubs
• Payroll submission — submitting in BambooHR by deadline; emailing the paper-check file to the Finance Director
• Bonuses & taxable wages — attendance and shift-pickup bonuses; gift cards/prizes after written authorization
• Mileage reimbursement — verifying submissions and processing at the policy rate
• Records & inbox — monthly PDF compilation to Google Drive; payroll@ inbox; 7-year retention

• 18+, high school diploma/GED (accounting/business degree preferred)
• Min. 2 years payroll or payroll-adjacent administrative experience; passes background check
• Strict confidentiality; ability to follow written policy exactly

Physical: remote, computer-based — extended sitting and screen work; reliable internet required.

Systems used:

The Finance Director oversees the agency’s full financial operation — accounting, financial reporting, accounts payable/receivable, organizational payee accounts, individual tax filings, departmental budgeting, reserves, and cash-flow protection. The role maintains all QuickBooks records, handles DMH billing and authorizations, and is an authorized party on all agency bank accounts. Final financial authority rests with the Executive Director.

• Accounting & records — all QuickBooks classifications, transactions, and monthly bank reconciliations
• Accounts payable & vendors — bills, rent/mortgage, utilities, insurance, W-9s, purchasing controls
• Financial reporting — monthly Balance Sheet, P&L, 30/60/90-day cash-flow, and Budget vs. Actual
• Budgeting — agency-wide and departmental budgets with quarterly Department Head reviews
• SSA payee accounts — compliant Organizational Payee records, monthly reconciliations, spend-down
• Individual finances — personal spending reports, tax filings, Renters Rebate, Christmas gifts, PEX cards, room & board ledgers
• DMH billing & variances — authorizations, monthly billing, ISL Variance forms within 30 days
• Payroll cost & reserves — protecting payroll as top priority; reserve fund (target $1,000,000)
• Controls & audits — internal controls, fraud reporting, audit/licensure readiness; supervises the QAP

• Strong QuickBooks and financial-systems expertise; banking authority
• Knowledge of SSA Organizational Payee and DMH/Medicaid billing regulations
• Budgeting and tax-coordination experience

Physical: office-based; no specific physical requirements stated.

Systems used:

The Maintenance Technician is an entry-level skilled-trades generalist who maintains, repairs, transports, and prepares the homes, vehicles, equipment, and facilities Abilities operates. It is a hands-on, physically demanding role spanning carpentry, basic plumbing and electrical, appliance troubleshooting, trailer operation, and grounds — keeping ISL homes safe, functional, and livable.

• Routine & corrective maintenance — plumbing, doors, appliances, flooring, drywall/paint, fixtures, upkeep
• Preventive & life-safety tasks — HVAC filters, smoke detector tests, fire extinguisher inspections
• Work orders — reviewing, updating, photographing, and closing tasks in Monday.com
• Purchasing & inventory — using purchasing cards within limits; receipts; inventory support
• Fleet & trailer transport — vehicle readiness/safety; hauling tools, furniture, and materials
• Grounds & seasonal — lawn care, snow removal, ice management (homes prioritized over the office)
• Emergency & after-hours response — flooding, outages, heating failures, severe weather

• 18+, high school diploma/GED, valid driver’s license with acceptable record, background check
• Baseline trades skills (hand/power tools, carpentry, basic plumbing/electrical, HVAC/appliance awareness)
• Reads a tape measure, gauges, and analog clock; provides own basic hand/cordless tools

Physical: demanding — lift/carry up to 75 lbs; crawl, kneel, crouch; enter crawl spaces/attics; climb ladders; work outdoors in all weather; drive while towing trailers.

Systems used:

The Maintenance Director leads, oversees, and executes all maintenance operations across ISL homes, the office, vehicles, and storage — preventive maintenance, repairs, emergency response, groundskeeping, fleet, inventory, contractor coordination, and compliance. The role prioritizes needs using a tiered support approach, keeps environments audit-ready, and carries significant responsibility for agency assets and safety systems.

• Department leadership — supervising technicians and seasonal staff; assigning and prioritizing work
• Work order management — prioritizing Monday.com orders by urgency/risk and verifying quality
• Preventive maintenance — HVAC, smoke detectors, fire extinguishers; protecting agency assets
• Emergency & after-hours response — directing repairs; snow/ice/severe-weather coordination
• Financial oversight — PEX monitoring, approving technician purchases up to $500, competitive bidding
• Contractors & fleet — vendor coordination; fleet records, inspections, and registration compliance
• Inventory & safety systems — items $20+ inventoried; evacuation plans, emergency kits
• Compliance & succession — audit readiness with the QAP; developing a Lead Technician

• Strong mechanical aptitude and broad knowledge of tools, carpentry, plumbing, electrical limits, HVAC, and vehicles
• Valid driver’s license with acceptable record; able to distinguish in-scope work from licensed-contractor work
• Physically able to perform and oversee hands-on work and assess safety risks firsthand

Physical: demanding leadership role — lift up to 50 lbs; kneel/stoop/bend; enter crawl spaces/attics; climb ladders; work outdoors; drive and tow trailers.

Systems used:

The Director of Culture & Experience designs, executes, and sustains the agency’s employee culture, recognition systems, internal engagement, and workplace environment. The role directly supervises HR, the Office Manager, and PRN Janitorial Staff while personally owning recognition programs, major agency events, internal communications, social media, culture metrics, and Tools of Choice training.

• Supervises HR, Office Manager & PRN Janitorial — setting priorities, standards, and timelines
• Recognition systems — WorkTango reporting, Abilibucks value integration, anniversaries, monthly giveaways ($2,400)
• Major agency events — Christmas Party ($20,000), Employee Appreciation Day ($15,000), DSP Appreciation Week
• Social media & storytelling — Facebook/Instagram, 3–5 posts/week, Canva graphics
• Culture metrics & budget — monthly dashboard, quarterly ED reporting, Culture Budget Tracker
• Employee morale concerns — first point of contact; Concerns Log; 24-hour escalation
• ISL support visits — minimum 4 drop-in visits/month logged in Monday.com
• Tools of Choice training & BambooHR Communities — ToC facilitation; replacing the Facebook group by Dec 31, 2026

• 3–5 years preferred leadership in culture/engagement/HR-adjacent or operational roles; staff supervision experience
• Strong organization, communication, systems thinking, and data tracking/reporting
• High EQ, empathy, confidentiality, DEI commitment; valid driver’s license & reliable transportation

Physical: regular local travel to ISLs/venues; lift event supplies up to 25 lbs; prolonged computer work.

Systems used:

The HR Manager owns all core HR operations for Abilities, LLC — hiring, onboarding, compliance documentation, employee relations, performance, leave, benefits, and separations. The role is the point of accountability for workforce compliance with Missouri DMH requirements, federal/state employment law, and agency policy, protecting the agency from employment-related risk.

• Recruitment & hiring — job postings in BambooHR (refreshed every 10 days), interviews, pre-hire forms
• Background checks & DMH compliance — initial and annual checks; tracking renewals and required documents
• Onboarding & orientation — BambooHR workflows, new-hire orientation, drug-test coordination, systems training
• E-Verify & I-9 — federal employment-eligibility compliance and timelines
• Performance & discipline — annual reviews and pay updates; corrective action; advising managers
• Separations & unemployment — exits, access termination, claims, appeals, and hearings
• Leave & accommodations — FMLA, ADA, Workers’ Compensation administration
• Benefits — AFLAC, Vitable, and Midwest Healthcare & Wellness, deductions, and open enrollment
• Policy, grievances & confidentiality — acknowledgment tracking (7-yr retention), grievances, HIPAA/ADA/FMLA

• 18+, high school diploma/GED (HR degree preferred); min. 2 years HR/personnel experience
• Knowledge of employment law, FMLA, ADA, Workers’ Comp, unemployment, and DMH/HCBS requirements
• Passes background check; maintains strict confidentiality

Physical: office-based — extended computer/sitting; lift up to 25 lbs occasionally; move through office.

Systems used:

The Quality Assurance Professional executes, monitors, and maintains agency-wide compliance systems for employee training, service documentation, internal audits, policy acknowledgments, and Room & Board ledgers. The role performs hands-on quality control — identifying deficiencies, completing entries, correcting errors, and escalating risks — to keep the agency audit-ready. It does not handle payroll, hiring, policy development, or financial transactions.

• Training compliance — monitoring training in BambooHR; scheduling renewals in WhenToWork (30 days out)
• Training records — maintaining BambooHR training folders with naming, dates, and retention
• Documentation oversight — enforcing SetWorks Activity Record standards and the return-for-correction workflow
• SetWorks audits — routine and targeted Activity Record audits with RPM remediation
• Unannounced ISL audits — ≥2 per month auditing PCSPs, due process, BSPs, spending and narcotics counts
• Room & Board / Payee ledgers — monthly deposits, deductions, allocations, and receipt uploads in SetWorks
• Policy signatures — reviewing the monthly BambooHR Policy Signature Report and issuing reminders

• 18+, high school diploma/GED; valid driver’s license with acceptable record; passes background check
• Able to follow written policies, procedures, and documentation standards precisely
• Completes and maintains required training

Physical: sit/stand for extended periods; travel to ISL homes; use stairs; lift/carry files up to 25 lbs.

Systems used: