Medicaid Managed Care Liaison
1 week ago
Reports to: Administrative Director of Nursing- Health Services
Locations: Marian Hall, Brooklyn, EFFC Burnside (Bronx) (Various Locations
Hours: 35 Hours, Non- Exempt (Position requires to staff to be onsite. Hybrid schedules are at discretion of Program Leadership following probationary period)
Job Summary:
Medicaid Managed Care Liaison (MMCPs) are responsible for ensuring there is a highly coordinated approach between Good Shepherd Health Services and the Medicaid Managed Care Plans (MMCPs). All 29-I VFCA Health Facilities are required to have a VFCA Medicaid Managed Care Liaison who will coordinate with the MMCPs. All MMCPs must have a Foster Care Liaison (FCL) who shall be the direct MMCP contact with 29-I VFCA Health Facilities, and work in collaboration with the MMCLs will for monitoring access to health care for children in foster care.
Responsibilities:
The VFCA Medicaid Managed Care Liaison will:
- Coordinate health care services and benefits with the following: 1. 29-I VFCA Health Facilities treatment team 2.
- MMCP's foster care liaison 3. LDSS's managed care foster care liaison 4. Health care providers, including school and community-based services 20 VFCA HEALTH FACILITIES LICENSE GUIDELINES DECEMBER 2024
- 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 insurance identification card
- Assist with foster care placement changes including: - Access to health care - Facilitate a single case agreement when a child is placed outside of the MMCP's service area or provider network
- Interact with clinical and billing staff • Refer children for needed services and assist in provider selection
- Maintain eligibility for public or private health insurance
- Assist with consent and/or confidentiality issues
- Oversee all Medicaid business functions
- Assist with court ordered services and fair hearings Central to the VFCA Medicaid Managed Care Liaison role is communication, both internally and externally. The 29-I VFCA Health Facility will communicate with MMCPs using secure phone, fax, and email. The 29-I VFCA Health Facility will develop and implement a system of communication and notification with MMCPs that includes:
- Mechanisms for sending and receiving information, including new enrollments or dis-enrollments from MMCPs
- Foster care intake and discharge status
- Changes in placement or address
- Changes in health status or provider This system of communication will include the use of the Medicaid Managed Care Foster Care and 29-I Transmittal Form which must be used for any of the following situations within required timeframes
Minimum Requirements
- High School Diploma/GED Required. Associate Degree is preferable
- Must have experience with Medicaid Managed Care
- Must have experience, expertise, and knowledge of the child welfare system &foster care healthcare requirements
- Understanding of the unique complex needs of the foster care population
- Familiarity with Medicaid Managed Care policies and procedures
- Ability to clearly communication both in writing and verbally
- Proficient in Microsoft Office (MS Word & Excel) Outlook Required
Revised TMH 10/8/25
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