County Eligibility Liaison

We are seeking a highly skilled County Eligibility Liaison to join our team at UnitedHealthcare. This role will play a critical part in ensuring that our members receive the necessary support and services to maintain their health and well-being.

• Serve as the liaison between the RAE, Medical Assistance Site/County Eligibility functions, CCBs, and the CMA.
• Collaborate with stakeholders to ensure collaboration with all county and Medical Assistance sites pertaining to application, renewal, case changes, or re-application status for members.
• Ensure proper follow-up and communication to support members in obtaining and maintaining their benefits.
• Respect confidentiality and maintain confidences as described in the UHG Employee Handbook and acknowledged through signature by all employees.
• Maintain confidentiality of patient information.
• Coordinate care for non-waiver services for members with intellectual and developmental disabilities where applicable or appropriate and work to resolve issues to make sure members receive the services they need in the designated service area.
• Provide case management services that includes intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department-prescribed IMS, resource development, and case closure.
• Contact the Member's at least once within each quarterly period, or more frequently if warranted by the Member's condition/or as determined by the rules of the LTSS Program in which the Member's is enrolled.
• Conduct face-to-face contact with the Member's at least every six (6) months, or more frequently if warranted by the Member's condition or the rules of the LTSS Program in which the Member is enrolled, and shall update the current approved assessment tool and Support Plan in the appropriate documentation system to reflect any changes in condition or services.
• Complete a new assessment during a face-to-face reassessment annually, or more frequently if warranted by the Member's condition or if required by the rules of the LTSS Program in which the Member is enrolled. Complete additional assessments as needed/required.
• Monitor the delivery of services and supports identified within the Support Plan and the Prior Authorization Request (PAR).
• Attend Department provided training for CMA agencies as well as agency provided in-service and staff development training.
• Conduct work that is in accordance with the CMA Contract Agreement's requirements. This includes but is not limited to, providing work that is accurate, timely, and complete.
• In the event, at any time throughout the case management process, the case manager suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation, or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency.
• May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed.

• Must meet one of the following:
• Bachelor's degree in one of the human behavioral science fields such as human services nursing, social work, psychology, public health.
• 5+ years of relevant experience.
• Combination of education and experience.
• 1+ years of experience with MS Office, including Word, Excel, and Outlook.
• Reliable transportation and the ability to travel up to 50-75% within assigned territory to meet with members and providers.
• Reside in Grand, Jackson, Rio Blanco, Moffat, or Routt Counties.

• Experience as a caseworker or case manager with LTSS population, in a private or public social services agency may substitute for the required education on a year for year basis.
• Knowledge or experience with Medicaid eligibility.