Managed Care Laison

1 month ago

Seneca, United States Lutheran Social Service of Minnesota Full time
Medicaid Managed Care Liaison

Regular Full-Time

West Seneca, NY, US

Requisition ID: 1132
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GA Family Services is seeking a Medicaid Managed Care Liaison. Since this position supports both the West Seneca and Jamestown locations, a strong candidate located in Jamestown, NY may be considered.

Purpose: All MMCPs must have a Foster Care Liaison who shall be the direct MMCP contact with VFCAs, care coordinators and service providers, and will be responsible for monitoring access to health care for children in foster care. This role coordinates with the Medicaid managed care plans as the liaison for GA and the youth enrolled in the managed care plans.

Qualifications: Prior experience, expertise and knowledge of the following: the child welfare system, healthcare requirements for children, medical and mental health needs of the foster care population, Medicaid policies and operations, and Medicaid Managed Care. Basic computer skills and a valid NYS Drivers License are required. Bachelors Degree, LPN or BSW, preferred.

Functions of the position:
  • Coordinate with the MMCP's foster care liaison
  • Inform and coordinate with the MMCP when a child's primary care provider needs to be changed
  • Be the primary contact person for the MMCP to assist with the following: MMCP enrollment, disenrollment and transitions. Immediate issuance of a Welcome Letter Securing identification showing the effective enrollment date (including immediate temporary identification). Replacement of insurance identification card.
  • Assist with foster care placement changes including: Access to healthcare. Facilitate a single case agreement when a child is place outside of the MMCPs service area or provider network and 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
  • Updates and maintains the foster care stipends and rate information for all foster care youth
  • Assists Clinical Supervisor in updating tracking information for all EBR packets and information for youth in FC and TFC
  • Coordinate TFC Billing. Duties include
    • Maintain daily census information
    • Prepare monthly bills/vouchers for payment
    • Prepare monthly revenue entry
    • Record monthly bills and payments to AR schedules
    • Work with Accounting Manager to transmit information to GL
    • Track outstanding accounts to keep accounts current
  • Tracking Clothing Allowance. Duties include:
    • Reimbursing parent for clothing expenses with accurate receipts
    • Monitoring clothing to make sure parents are not over/under spending
  • Will develop and implement system of communication and notification with MMCPs that includes mechanisms for sending and receiving information, including new enrollments from MMCPs, Foster Care Intake and Discharge status, changes in placement or address, changes in health status or provider.
  • Provides advice and participates when appropriate in medical in-service training programs
  • Demonstrates compliance with all federal and state laws and regulations
  • Meets regularly with the Director of Community Based Programs on the 29I and ongoing Medicaid Managed Care issues/updates
  • Attends all needed meetings with the agency and OCFS on the 29I updates/trainings and keep the Director of Community Based Services and other leadership team members informed of status and changes

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