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7 days ago
The Medicaid Managed Care Liaison is the primary point of contact for Medicaid Managed Care Plans (MMCP). This role requires expertise in the child welfare system, foster care healthcare requirements, and Medicaid Managed Care policies and procedures.
Duties and Responsibilities- Coordinate with MCO (Managed Care Organization) Foster Care Liaison
- Inform and coordinate PCP (Primary Care Physician) changes
- Assist with plan enrollment, disenrollment, and transitions
- Issue plan Welcome letters
- Secure plan ID showing effective date
- Assist in ID card replacement
- Assist with foster care placement changes, including access to healthcare and facilitating single case agreements when a child is placed outside of the MMCPs service area or provider network
- Interact with clinical and billing staff
- Refer children for needed services and assist in provider selection
- Coordinate with healthcare providers, including schools and community-based services
- Maintain eligibility for public or private health insurance
- Assist with consent and/or confidentiality issues
- Obtain authorizations from all MCO
- Update the AccuMedic (EHR) system with the authorization information to ensure proper billing occurs
- Take care of general office duties, such as answering the telephone and triaging calls, maintaining office supplies, preparing time sheets, and maintaining clinical staff schedules in Microsoft Outlook
- Assist Foster Care and Group Home programs with access to care
- Oversee and support program audits
- Responsible for closed medical records
- Arrange Single Case Agreements with out-of-network placements
- Billing and Clinical Staff interaction
- Referrals to services
- Coordinate care with providers, including schools and Community-Based services
- Assist with consent/confidentiality issues
- Assist with Fair Hearings/Court-ordered services
- Schedule clinical appointments, make reminder calls, and track kept and not kept appointments
- Create and maintain a tickler system for child-specific mandated services in developmental and mental health treatment
- Type clinical reports, memos, letters, and other reports for the department
- Photocopy, distribute, and file reports and other written materials
- Log and distribute requests for clinical services to appropriate staff
- Distribute and track completed clinical reports
- Track Continuing Education credits, licensure, and malpractice insurance of clinicians
- Prepare and maintain records of department purchases
- Handle incoming and outgoing mail for the department
- Maintain up-to-date treatment case lists on each clinician
- Interact with clinical and billing staff
- Oversee all business functions
Experience: Minimum 3 years of experience in a medical or social services office environment. Knowledge and use of computers. Experience with Electronic Health Records is a plus. Excellent typing and data entry skills. Familiarity with NYS Child Welfare protocols. Organizational skills. Good communication and collaboration skills.
Required background checks: NYS Statewide Central Register of Child Abuse and Maltreatment (SCR) NYS Sex Offender Registry (SOR) NYS Division of Criminal Justice Services (DCJS) fingerprinting NYS Justice Center Staff Exclusion List (SEL) NYS OMIG Medicaid Exclusion List Complete mandated reporter training
Education: High school diploma minimum; BA/BS/MPA preferred
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