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Lead Care Coordinator

4 months ago

Reno, United States Access To Healthcare Network Full time
Job DescriptionJob Description

Job Purpose: The Lead Care Coordinator will help improve the health outcomes for clients living with HIV/AIDS, providing services, and assisting clients to obtain access to other public and private programs by enrolling into Ryan White. The Lead Care Coordinator will determine the payer source for ADAP services. This entails ensuring that RW members are meeting their obligations to AHN, to our providers, and to the grantors of the program. The Lead Care Coordinator will also advocate, and problem solve on behalf of our consumers to ensure that they receive a continuum of care and support. Ensuring this continuum of support requires that the Lead Care Coordinator completes all funding guidelines and reporting requirements. The Lead Care Coordinator will assist with scheduling appointments, maintaining spreadsheets, assisting with high call volume, as well as determining and tracking payer sources for ADAP services. The Lead Care Coordinator will assist in the development and continual improvement of the Access to Healthcare Network Ryan White Program.

Key Responsibilities and Accountabilities

  • Gain a clear and working knowledge of the HIV/AIDS Drug Assistance Program (ADAP); establish and maintain appropriate working relationship with persons and agencies involved.
  • Gain clear and working knowledge of granting NMAP (ADAP) dates based on payer of last resort rule (30 days vs full NMAP dates).
  • Learn, and follow, the payer of last resort rule at all times.
  • Screen eligibility applications received from Part A and Part B agencies to verify the application is completed correctly and all required documents are attached for eligibility and ADAP services.
  • Manage all incoming eligible Ryan White referral data entry from Part A and Part B CAREWare systems in a timely manner (5 business days for Part A, 14 business days for Part B).
  • Maintain referral workflow.
  • Assign and organize referrals along with referral spreadsheets.
  • For Part A Referrals-ability to transfer (mirror) incoming referral data from Part A to Part B and Salesforce.
  • For Part B Referrals-Ability to transfer (mirror) incoming referral data from Part B to Salesforce.
  • Ability to Input information quickly and accurately from a variety of sources into a computer database.
  • Assist in providing EIVF to consumers.
  • Ability to complete referrals to HIP/CSAP as needed for their services (enrolling into on or off exchange, help with Health Insurance Premiums, co-pays or deductibles, tax program, etc.).
  • Have a working knowledge of Non-AHN health care programs such as Medicaid, Medicare, Nevada Check-Up, Prescription Drug Programs.
  • Follow up with clients or partner agencies for missing documents preventing the completion of eligibility mirroring.
  • Completing the process of updating interim eligibility changes by obtaining proof of the changes, updating the application and all systems.
  • Ability to manage assigned caseload of a diverse population of HIV-infected individuals and respectfully interact with clients while working cooperatively in a team environment.
  • Fulfill parts of the Scope of Work for the Nevada Department of Health and Clark County Nevada
  • Assist with obtaining and entering labs (CD4 count and Viral Load) into CAREWare A.
  • Ability to be both compassionate and professional while serving the program population.
  • Return all phone calls, emails, or written correspondence within 48 hours of receipt.
  • Submit all programmatic reports on time, in a professional format and with accurate data.
  • Gain clear and working knowledge of Access to Healthcare Network services available to our members and be able to use the AHN database to locate information and perform basic job functions.
  • Process, maintain and gather protected health information from clients in a manner compliant with all HIPAA regulations.
  • Develop and maintain effective working relationships with AHN providers, members, program partners and program funders.
  • Be able to multitask and critically think though a variety of situations.
  • Must be proficient in Microsoft Office, particularly Excel, Word and Outlook.
  • Abide by all HIPAA requirements.
  • Submit all programmatic reports on time, in a professional format and with accurate data.
  • Gain clear and working knowledge of Access to Healthcare Network services available to our members and be able to use the AHN database to locate information and perform basic job functions.
  • Process, maintain and gather protected health information from clients in a manner compliant with all HIPAA regulations.
  • Develop and maintain effective working relationships with AHN providers, members, program partners and program funders.
  • Be able to multitask and critically think though a variety of situations.
  • Must be proficient in Microsoft Office, particularly Excel, Word, and Outlook.
  • Abide by all HIPAA requirements.
  • Run Emergency referral reports for both Part A and Part B twice a day.

OTHER REQUIREMENTS:

  • Perform general administrative duties for Access to Healthcare Network when needed and/or requested.
  • Field inquiry calls from interested parties, including potential members. Explain program requirements, in both the Ryan White Part B Eligibility Program and the Ryan White Part A Eligibility Program. Make timely disposition of calls and take appropriate actions on inquiry calls and referrals.
  • Gain a clear and working knowledge of all Access to Healthcare Network administrative duties.
  • Flexibility, each department selects the hours of work schedule for the department staff based on the department's needs. This schedule may change at any time according to the department's needs.
  • Gain a clear and working knowledge of the Nevada Check-Up, Medicare, ACA and Medicaid enrollment criteria and process; establish and maintain appropriate working relationships with persons and agencies involved.
  • Complete appropriate copying, faxing and large-scale mailings.
  • Required to pass a background check through the State of Nevada
  • Subject to Medicare/Medicaid fraud background check.
  • Required to obtain a Community Health Worker course Certification within the first year of employment at the agency's expense.
  • May be required to obtain an Exchange Enrollment Facilitator License (EEF) at the agency's expense.

QUALIFICATIONS:

  • Spanish bilingual preferred.
  • Minimum Education: High School Diploma; AA Degree Preferred.
  • One year minimum working in health care related social work, with experience in medical billing and patient coordination preferred.
  • One year minimum general office duty experience such as typing, filing, and faxing.
  • Two years' experience working with databases and software programs such as Microsoft word, excel, PowerPoint and Vision.
  • Excellent organizational skills.
  • Be able to sit at a computer for 6 - 8 hours per day.
  • Be able to stand between 3 - 6 hours per day.
  • Be able to withstand hand/wrist deviation and repetition.
  • Excellent communication and customer service skills.
  • Must have a valid driver's license and be able to drive the AHN Company Car when needed.
  • Must be able to lift, carry up to 30 pounds with a fair consistency.

Work Environment

The noise level in the work environment is usually moderate and the employee usually works in a climate-controlled office environment.

**The statements herein are intended to describe the general nature and level of the position, but are not necessarily a complete list of responsibilities, duties and skills required of employee(s) so classified. As such, responsibilities, duties, and required skills may be changed, expanded, reduced, or deleted to meet the business needs of Access to Healthcare Network. Furthermore, they do not establish a contract or implied contract for employment. **

As an equal opportunity employer, we are committed to identifying and developing the skills and leadership of people from diverse backgrounds. We encourage all qualified candidates to apply.