Intake Navigator II

4 weeks ago

Brooklyn, New York, United States CenterLight Health System Full time
Job Title: Intake Navigator II

CenterLight Health System is seeking a highly skilled and detail-oriented Intake Navigator II to join our team. As a key member of our enrollment team, you will be responsible for educating prospective participants about our program, ensuring a smooth and efficient enrollment process, and maintaining compliance with state and federal regulations.

Key Responsibilities:
  • Provide plan education and qualification screening to prospective participants
  • Respond to incoming and outgoing calls, data entry, emails, and schedule assessments
  • Meet departmental productivity goals and contribute to the growth of the company
  • Become an expert on CenterLight PACE program eligibility requirements, services, and benefits
  • Address eligibility issues, application processing, and referrals to Maximus to resolve potential participant issues
  • Work closely with all departments to onboard and retain participants
  • Obtain referral details to assess and determine appropriate next steps for expeditious enrollment processing
  • Evaluate factors unique to each referral, including clinical condition, financial situation, entitlement status, and home support systems
  • Use knowledge obtained through qualification screening to determine which government agencies and team members should be assigned to the prospect or caregiver in the next step of enrollment
  • Verify plan and entitlement status using LDSS/HRA/CMS resources and functions
  • Perform provider network verification and other validation of provider participation
  • Enter calls/inquiries into a central database for tracking and follow-up and schedule appointments with the prospect/caregiver
  • Monitor and report Intake team performance measures to improve delivery and execution of onboarding procedures
  • Maintain and generate reports to measure performance and quality of work as set forth by CenterLight
  • Participate in implementing workflows and Standard Operating Procedures
  • Advise on the development of tools and process improvements to increase quality and departmental operational efficiencies
  • Collect and review completeness of all required documents for processing enrollment transactions and reconciliation of enrollment files
  • Provide training and process orientations to Business Development team members and other business functions as needed
  • Maintain knowledge of all applicable CMS, DOH, and PACE-specific guidelines, including organizational and departmental policies and procedures
  • Maintain compliance with Medicaid, Medicare, and PACE regulations
Requirements:
  • HS Diploma required; Associate Degree preferred
  • Minimum 2 years work experience in healthcare, preferably with MLTC, MAP, or PACE programs and/or homecare; primarily in intake/enrollment functions
  • Knowledge of Medicaid, Medicare, and PACE regulations for eligibility and enrollment
  • Proficiency with CRM platforms; knowledge of Care Compass strongly preferred
  • Knowledge of Maximus, eMedNY, ePACES, CMS MARx, and other related HRA/CMS resources and functions, preferred
  • Proficiency in Microsoft Excel, Word, Outlook, and Teams
  • Excellent interpersonal skills, along with demonstrated ability to handle situations requiring immediate and urgent attention, while meeting targets and projections and performing daily tasks
  • Highly organized and flexible to meet submission deadlines
  • Experience in working independently without significant oversight and/or direction from a supervisor
  • Comprehensive understanding of federal and state regulatory requirements with respect to healthcare eligibility, coverage, and services of various public programs a plus
  • Familiarity with healthcare organizations and general population dynamics within the greater New York Metropolitan region a plus
Physical Requirements:
  • Standing - Duration of up to 6 hours a day
  • Sitting/Stationary positions - Sedentary position in duration of up to 6-8 hours a day for consecutive hours/periods
  • Lifting/Push/Pull - Up to 50 pounds of equipment, baggage, supplies, and other items used in the scope of the job using OSHA guidelines, etc.
  • Bending/Squatting - Have to be able to safely bend or squat to perform the essential functions under the scope of the job
  • Stairs/Steps/Walking/Climbing - Must be able to safely maneuver stairs, climb up/down, and walk to access work areas
  • Agility/Fine Motor Skills - Must demonstrate agility and fine motor skills to operate and activate equipment, devices, instruments, and tools to complete essential job functions (ie. typing, use of supplies, equipment, etc.)
  • Sight/Visual Requirements - Must be able to visually read documentation, papers, orders, signs, etc., and type/write documentation, etc. with accuracy
  • Audio Hearing and Motor Skills (language) Requirements - Must be able to listen attentively and document information from patients, community members, co-workers, clients, providers, etc., and intake information through audio processing with accuracy. In addition, they must be able to speak comfortably and clearly with language motor skills for customers to understand the individual
  • Cognitive Ability - Must be able to demonstrate good decision-making, reasonableness, cognitive ability, rational processing, and analysis to satisfy essential functions of the job

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