Overview:
Provides support to prospective members, members and their families including community resource planning, advocacy, skill building, linking patient/families to community resources and providing assistance with entitlements. Works closely with client, support system and/or family to obtain Medicaid and connect client to appropriate MLTC in the community. Works under close supervision.
Responsibilities:
What We Provide
Referral bonus opportunities
Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
Employer-matched 401k retirement saving program
Personal and financial wellness programs
Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program
Generous tuition reimbursement for qualifying degrees
Opportunities for professional growth and career advancement and CEU credits
What You Will Do
Performs outreach to community agencies in order to establish working relationships and provides access to other services. Advises other agencies of the program and referral process.
Works closely with client, support system and/or family to obtain Medicaid and connects client to appropriate MLTC in the community. Conducts face-to-face encounters with members to aid assessment process, as needed.
Screens financial records of clients/families to assist in assessment of enrollment eligibility.
Contacts the appropriate program staff to recommend third party reimbursement, entitlements and community resources for clients/families to ensure that they have access to the adequate entitlement benefits.
Maintains records and statistics in accordance with program requirements. Documents services planned and provided; maintains written and verbal communication records according to VNS Health policies.
Participates in clinical team meetings; works collaboratively with other VNS Health Plans staff to ensure that prospective members/ members have appropriate Medicaid eligibility and receive appropriate MLTC services.
Arranges transportation and/or appointments for members to relevant offices/ sites, as needed.
Attends in-service education programs and other training as required by VNS Health and funding sources.
Assumes responsibility for continued professional growth.
Participates in special projects and performs other duties as assigned.
Qualifications:
Licenses and Certifications:
Valid driver’s license may be required, as determined by operational needs.
Education:
Associate's Degree in a relevant field, or the equivalent combination of education and work experience Required
Work Experience:
Minimum of two years’ work experience in a health care or human services setting Required
Knowledge of Medicaid eligibility and Medicaid Managed Care regulations Preferred
Bilingual skills may be required, as determined by operational needs.