Medicaid Managed Care Liaison

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