Care Coordinator

Best Place to Work in Northern Nevada - 1st Place Winner 2024Best Place to Work for Working Parents - 2024Check out our AWESOME Benefits4 weeks Paid Time Off in the First Year - Front Loaded14 paid holidays annuallyHybrid Work Options Available403B Retirement Plan with 4% Match4 Weeks Paid Parental LeaveUp to 4 Weeks Paid Catastrophic LeaveMedical, Dental, and Vision benefits - effective 1st day of the month, following date of hireFree Health Insurance Options for Full Time EmployeesLow-Cost Health Insurance Options for DependentsEmployee Hardship Loan ProgramFree Life Insurance and Long-Term DisabilityTuition AssistanceContinuing Education SupportDog Friendly WorkplaceChild Friendly WorkplaceGreat Organizational CultureJOB PURPOSE: The 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 Care Coordinator will determine 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 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 Care Coordinator complete all funding guidelines and reporting requirements. The 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 Care Coordinator will assist in the development and continual improvement of the Access to Healthcare Network Ryan White Program.BASIC REQUIREMENTS: Bilingual (English/Spanish) mandatory.Must have a valid driver license and be able to drive the AHN company car when needed.Required to pass a background check through the State of Nevada.Subject to Medicare and Medicaid fraud background check.Required to obtain a Community Health Worker Certification within the first year of employment at the agency's expense.Must be able to obtain an Exchange Enrollment Facilitator License (EEF) at the agency's expense.Gain a clear and basic knowledge of Access to Healthcare Network administrative duties, services, and systems.Complete appropriate copying, faxing and large-scale mailings.Abide by all HIPAA requirements.Must attend staff meetings and be willing to meet with direct supervisor on a consistent and regular basis.KEY RESPONSIBILITIES AND ACCOUNTABILITIES:Gain clear and working knowledge of granting NMAP (ADAP) dates based on payer of last resource rule (30 days vs full NMAP dates).Always learn and follow the payer of last resort rule.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). 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.Gain a clear and working knowledge of non-AHN health care programs such as: ACA, Medicaid, Medicare, Nevada Check-Up, Prescription Drug Programs.Follow up with clients for missing documents preventing the completion of eligibility mirroring/renewals.Completing the process of updating interim eligibility changes by obtaining proof of the changes, updating the application and all systems.Fulfill parts of the Scope of Work for the Nevada Department of Health and Clark County Nevada. Ability to Input information quickly and accurately from a variety of sources into a computer database.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.).Assist with obtaining and entering labs into CAREWareAbility to manage an assigned caseload of a diverse population of People Living with HIV/AIDS.Respectfully interact with consumers while working cooperatively in a team environment.Return all phone calls, emails or written correspondence within 48 hours of receipt.Develop and maintain effective working and compassionate relationships with staff, providers, members, program partners, and program funders.Be able to multitask and critically think though a variety of situations.Gain a clear 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.Gain a clear and basic knowledge of: CAREWare A/B, Magellan, Salesforce, and RWISE.Gain a clear and working knowledge of the HIV/AIDS Drug Assistance Program (ADAP); establish and maintain appropriate working relationships with the persons and agencies involved. Run Emergency referral reports for both Part A and Part B twice a day.Submit all programmatic reports on time, in a professional format and with accurate data.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.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.Other duties as assigned.EDUCATION MINIMUM:High School Diploma required; AA Degree preferred.EXPERIENCE MINIMUM:One year working in health care related social work.One year of general office duty experience such as: typing, filing, and faxing.Must be proficient working with databases and software programs such as: Microsoft Word, Excel, and Outlook.Experience in medical billing and patient coordination preferred.Excellent organizational skills.Excellent communication and customer service skills.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.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.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.