PCS Compliance Monitor

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Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting.

You must complete all required portions of the application and attach the required documents in order to be considered for employment.

Department
Design and Covered Services

Job Summary

Job Description

• Assists the Department with conducting survey calls for all Chisholm class members who receive Early Periodic Screening Diagnostic Treatment Personal Care Services (EPSDT PCS).
  • Contacts providers to ensure that workers are ready to start on the first day of the certification period.
  • Ensures that a worker is providing services in the home, if the Prior Authorization is a renewal.
  • Documents if there are no workers in the home and offers support.
    • Offers assistance if the responsible party reports that the recipient is not receiving all authorized hours.
    • Closes referrals if the families refuse assistance.
    • Contacts the family to discuss the barriers and issues with the receipt of services.
  • Locates a willing and able Personal Care Services provider within 10 days.
  • Contacts the provider if there is no approved Prior Authorization or all the hours aren't being covered for a current Prior Authorization. Documents all of this information in the Chisholm Services Monitoring System.
  • Emails the provider if there are unsuccessful attempts to reach them by phone or fax.
  • Relays the Support Coordinator the Prior Authorization number, certification period, units approved and the date the notice was mailed.
  • Contacts the family and verifies the hours that are being received and documents this information in the Daily Log and the Chisholm Services Monitoring System.
  • Makes contact every 14 day or 2 weeks for 3 months once services begin; after the initial 3 months, calls the responsible party on a monthly basis until the PA has expired.
  • Documents all survey calls in the Chisholm Services Monitoring System. Sends our reminders to the family and the provider, one month prior to the end date of the PA, notifying them that the PA is ending and advising all parties regarding the necessary documents that are needed for the renewal of services.
• Provides backup coverage of the toll free Prior Authorization Liaison (PAL) line for complaints regarding the delivery of Medicaid services.
• Provides back-up coverage for the internal LDH PAL, receiving, logging, and assigning incoming PAL referrals.
• Attends meetings and assists the Program Manager as necessary.
• Develops monthly reports of required phone call activities.
• Organizes and files related paperwork.
• Other tasks as directed.

QUALIFICATIONS REQUIRED:

• Bachelor's degree or 6 years of professional work experience in lieu of degree.
• Excellent analytical skills, effective organizational and time management skills.
• Great attention to detail and follow up, and verbal/written communications skills.
• Able to set, follow and meet scheduled deadlines.

DESIRED:

• Advanced degree
• Minimum 1 year of professional experience working with Early Periodic Screening Diagnostic Treatment Personal Care Services (EPSDT PCS), legal/paralegal, or home health background/experience.
• Minimum 1 year of professional experience in healthcare field and/or dealing with federal/state health care programs.
• Minimum 1 year of professional experience with compliance and/or project management activity.
• Minimum 1 year of professional experience working with Medicaid program support.

SALARY: 37-57k

Required Attachments

Please upload the following documents in the Resume/Cover Letter section.

• Detailed resume listing relevant qualifications and experience;
• Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems;
• Names and contact information of three references;

Applications that do not include the required uploaded documents may not be considered.

Posting Close Date
This position will remain open until filled.

Note to Applicant:

Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.

References will be contacted at the appropriate phase of the recruitment process.

This position may require a criminal background check to be conducted on the candidate(s) selected for hire.

As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.

The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.

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