Professional, Clinical Coordinator LTSS

1 month ago

Schenectady, United States MVP Health Care Full time
Professional, Clinical Coordinator LTSS

625 State St, Schenectady, NY 12305, USA • Rochester, NY, USA • Tarrytown, NY, USA Req #1770

Tuesday, October 17, 2023

Over 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds-tech people, numbers people, even people people-working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference-it's time to make a healthy career move to MVP

Status: Full Time, Exempt

The Clinical Coordinator (CC) will work directly with customers, their families and/or advocates to ensure that the member has access to MVP resources offered through the Long-Term Support and Services (LTSS) Program. The CC works collaboratively with the RN case manager to support, promote, and facilitate engagement in the LTSS Case Management Program. The CC will work as a bridge between the customer, the health plan, and the Community based Organizations to create a seamless and positive experience to fulfill their unmet care needs. The CC will build individual capacity by increasing health and wellness self-management skills and sufficiency through a series of activities such as outreach, education, encouragement t, social supports, and advocacy. The CC is responsible to evaluate the needs and of the customer in between assessment timeframes and I accountable to inform the RN case manager of any changes in member status between formal assessments. The CC will empower the customer to make informed decisions and advocate on their behalf when deemed necessary.

The CG will collaborate with a broader team, including but not limited to Case Management, Social Work and the Medical Director. T he CC will develop care plan interventions which maintain cost effective care and reduce/resolve challenges or barriers so that the customer may achieve their optimal level of health, independence, safety, and well-being. In this role, the CC will communicate regularly (as determined by the RN Case Manager) with the member to promote member engagement, utilization of Plan benefits to enhance their health and access while supporting overall satisfaction.

Responsibilities:

  • Build lasting relationships with members, families, and caregivers.
  • Conduct new Member Medicaid Long Term Support Services (LTSS) follow up calls and completion of the members ongoing SDOH assessments.
  • Ensure complete communication feedback to/from customers regarding service delivery, their ongoing health status, and other post-enrollment activities.
  • Promote customer understanding of their diagnosis and treatment plan.
  • Assist customers in addressing unmet needs and recommend community-based supports as necessary.
  • Facilitate reduction of care disruption or delays in care.
  • Facilitate access to services which are culturally appropriate, meet the customers' stated need for service and enhance the quality-of-service delivery.
  • Promote knowledge of health delivery system(s) to empower member into self-care management.
  • Support patient-centric strategies to improve health and wellness in collaboration with the RN Case Manager,
  • Collaborate with MVP Quality Management to support performance measurements.
  • Facilitate resolution of real and perceived disruptions of care as the customer enrolls in MVP LTSS program.
  • The CC will perform other duties as assigned by management.

Position Qualifications:

Minimum Education:

Bachelor's Degree in a Health or Human Service field preferred or combination of an Associate's Degree in a health or human services field and two years of experience working within managed care or health services environment or five years of experience as a service coordinator with any population.

Minimum Experience:

Working knowledge of Medicaid l programs.

Extensive knowledge and experience with Medicaid LTSS benefits community organizations, social services, and public resources.

Experience in Managed Care and/or working with Medicaid, or Social Service Agencies a plus.

Required Skills:
  • practices and information into day-to-day customer engagement. Ability to incorporate Evidence Based Innovation (EBI)
  • Ability to collaboratively work with team to assist and resolve member concerns and complaints.
  • Ability to adhere to New York State Medicaid regulatory guidelines.
  • Understanding of the time tasking tool, person centered plan of car and the NFloc scoring methodology.
  • Highly organized; capacity to work independently and able to manage multiple priorities appropriately; strong ability to do follow-up.
  • Ability to communicate independently and directly with members, providers and staff with calmness, assertiveness, diplomacy and in a non-confrontational manner.
  • Strong communication skills, both verbal and written.
  • Proficient in computer skills
  • Valid driver's license and access to reliable daily transportation
  • Ability to work independently and maintain flexibly in fast paced start up environment.

Preferred Skills:
  • Bilingual communication (oral and/or written) is an asset.

Level of Supervision:
  • Minimal

About MVP

MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.

At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors , including but not limited to geographic location ; relevant experience, education, and training; and the nature of and demand for the role.

In addition, we offer a comprehensive benefits package that includes:

  • Considerable paid time away from work including PTO (Paid Time Off), s ick t ime, service t ime o ff, p aid h olidays, and f loating h olidays , allowing you to take time off when it suits you best.
  • Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
  • Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
  • Life insurance and disability coverage to ensure financial security for you and your dependents.
  • An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
  • Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
  • A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
MVP Health Care analyzes the latest market data to determine employee compensation. Compensation figures listed in a job posting are subject to change as new market data becomes available. The salary range, other compensation, and benefits information is accurate as of the date of this posting. MVP Health Care reserves the right to modify this information at any time, subject to applicable law. More detailed information about total compensation and benefits will be provided during the hiring process.

MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com

Please apply and learn more - including how you may become a proud member of our team.

Other details
  • Job Family Medical Management/Clinical
  • Pay Type Salary
  • Min Hiring Rate $44,850.00
  • Max Hiring Rate $81,717.00

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