Job Information
Abbott House Medicaid Managed Care Liaison in Bronx, New York
Job Summary:
The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must have experience, expertise, and knowledge of:
The child welfare system
Foster care healthcare requirements
The unique complex needs of the foster care population
Medicaid Managed Care policies and procedure
The Medicaid Managed Care Liaison is a full-time position.
Duties and Responsibilities:
29I Core Services
Coordinate with MCO (Managed Care Organization) Foster Care Liaison
Inform and coordinate PCP (Primary Care Physician) changes
Assist with plan enrollment, disenrollment, and transitions
Issue plan Welcome letters
Secure plan ID showing effective date
Assist in ID card replacement
Assist with foster care placement changes including: - Access to health care - Facilitate a single case agreement when a child is placed outside of the MMCP’s service area or provider network
Interact with clinical and billing staff
Refer children for needed services and assist in provider selection
Coordinate with health care providers, including school and community-based services
Maintain eligibility for public or private health insurance
Assist with consent and/or confidentiality issues
Obtain authorizations from all MCO
Update the AccuMedic (EHR) system with the authorization information to ensure proper billing occurs
Health Services Supervisor
Take care of general office duties such as answering telephone and triaging calls, maintaining office supplies, preparing time sheets, and maintaining clinical staff schedules in Microsoft Outlook.
Assist Foster Care and Group Home programs with Access to care.
Oversee and support program audits
Responsible for closed medical records
Arrange Single Case Agreements with out of network placements
Billing and Clinical Staff interaction
Referrals to services
Coordinate care with providers including schools and Community Based services.
Assist with consent / confidentiality issues.
Assist with Fair Hearings / court ordered services.
Schedule clinical appointments, make reminder calls, and track kept and not kept appointments.
Create and maintain tickler system for child-specific mandated services in developmental and mental health treatment.
Type clinical reports memos letters, and other reports for the department.
Photocopy, distribute, and file reports and other written materials.
Log and distribute requests for clinical services to appropriate staff.
Distribute and track completed clinical reports.
Track Continuing Education credits, licensure, and malpractice insurance of clinicians.
Prepare and maintain records of department purchases.
Handle incoming and outgoing mail for the department.
Maintain up-to-date treatment case lists on each clinician.
Interact with clinical and billing staff
Oversees all business functions
Perform other secretarial duties as requested by Medical Director.
Any other related duties as required
Educational & Experience Requirements:
Experience:
Minimum 3 years’ experience in a medical or social services office environment.
Knowledge and use of computers.
Experience with Electronic Health Records a plus.
Excellent Typing skills.
Excellent Data entry skills.
Familiar with NYS Child Welfare protocols.
Organizational skills.
Good Communication and collaboration skills.
Required background checks:
NYS Statewide Central Register of Child Abuse and Maltreatment (SCR)
NYS Sex Offender Registry (SOR)
NYS Division of Criminal Justice Services (DCJS) fingerprinting
NYS Justice Center Staff Exclusion List (SEL)
NYS OMIG Medicaid Exclusion List
Complete mandated reporter training
Education:
High school diploma – minimum; BA/ BS/ MPA preferred
Job Type: Full-time
Salary: $35,000.00 - $38,000.00 per year
Benefits:
Dental insurance
Employee assistance program
Employee discount
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Retirement plan
Tuition reimbursement
Vision insurance