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PCM Intake and Consumer Support

4 months ago

Stoughton, United States Tempus Unlimited Inc. Full time
Job DescriptionJob DescriptionDescription:

Tempus Unlimited is looking for a support staff to answer phones, provide consumer support, and distribute calls to appropriate department for the Personal Care Management Prior Authorization Department. Bilingual Spanish or Haitian Creole required.


Essential Functions

  • Consumer Support
  • Check and return all received voice and email messages as soon as possible or no later than 72 hours.
  • Log all incoming calls in the consumer database and maintain phone log according to MassHealth/PCM contract.
  • Combine phone log and produce weekly report of return call as assigned.
  • Update any changes (of address and phone number) received in database and notify designed staff in Skills Training and Evaluation Department (Refer to Incoming Call Procedures).
  • Referral as assigned
  • Receive referral inquiries via phone and fax (may include coordinating electronic referrals).
  • Screen referral to ensure applicant meets minimum requirements for appropriate services through Options (Refer to Community Services PCA Standard Operating Procedures).
  • Process new referrals in Consumer Database, including Senior Care Options (SCO) and 1Care and notify Skills Trainer Supervisor (Refer to Community Services PCA Standard Operating Procedures).
  • Request medical documentations to applicant’s doctor for current medical summary, including diagnosis and any pertinent records.
  • Update consumer information in the database as needed during the referral process (i.e. MD info, spelling errors, etc.).
  • Request Visiting Nurse Association (VNA) 485 Care Plan, Department of Developmental Services/Mass. Rehab Commission/Department of Children’s and Family (DDS/MRC/DCF) contracts, and other supporting documentation (refer to Community Services Standard Operating Procedures).
Requirements:

Preferred Experience

  • Accuracy and attention to detail
  • Must have the ability to maintain confidentiality at all times
  • Experience servicing people with disabilities who are living in the community-familiarity with other disability-related services
  • Familiarity with MassHealth PCA program preferred

Required Certificates, Licenses, Registrations, skills, abilities

  • High School Diploma or equivalent
  • Spanish bilingual required Spanish or Haitian Creole
  • Professional telephone manner, computer database skills, familiarity with office procedures and equipment
  • Excellent communication skills
  • Excellent interpersonal skills
  • This position requires the utmost cooperation in providing a positive environment to create a productive workplace

Work Authorization/Security Clearance

All offers of employment made by Tempus Unlimited are contingent upon satisfactory background check results. Pre-employment background checks will be conducted on all candidates that are offered a position at the agency in compliance with program policy as well as state and federal regulations. From time to time, these checks may be conducted on current employees to ensure compliance with all state and federal regulations and contracts.


EEO Statement

Equal Employment Opportunity is a fundamental principle at Tempus Unlimited where employment from recruiting through the end of employment is based upon professional capabilities and qualifications without discrimination because of race, color, religion, sex, age, sexual orientation, veteran status, national origin, disability or any other characteristic as established by law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

Other Duties

  • Must report all suspected incidents of consumer sexual/physical abuse and neglect to the Disabled Person Protection Commission (DPPC).
  • Must report all suspected fraud to your Supervisor or Program Director
  • Perform other duties as assigned by Supervisor or Program Director

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.