Medicaid Managed Care Liaison

Job Summary:The Medicaid Managed Care Liaison is the primary contact person for the Medicaid Managed Care Plans (MMCP). MMC Liaison must have experience, expertise, and knowledge of:The child welfare systemFoster care healthcare requirementsThe unique complex needs of the foster care populationMedicaid Managed Care policies and procedureThe Medicaid Managed Care Liaison is a full-time position.Duties and Responsibilities:29I Core ServicesCoordinate with MCO (Managed Care Organization) Foster Care LiaisonInform and coordinate PCP (Primary Care Physician) changesAssist with plan enrollment, disenrollment, and transitionsIssue plan Welcome lettersSecure plan ID showing effective dateAssist in ID card replacementAssist 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 networkInteract with clinical and billing staffRefer children for needed services and assist in provider selectionCoordinate with health care providers, including school and community-based servicesMaintain eligibility for public or private health insuranceAssist with consent andor confidentiality issuesObtain authorizations from all MCOUpdate the AccuMedic (EHR) system with the authorization information to ensure proper billing occursHealth Services SupervisorTake care of general office duties such as answering 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 auditsResponsible for closed medical recordsArrange Single Case Agreements with out of network placementsBilling and Clinical Staff interactionReferrals to servicesCoordinate 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 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 teract with clinical and billing staffOversees all business functionsPerform other secretarial duties as requested by Medical Director.Any other related duties as requiredEducational & Experience Requirements:Experience:Minimum 3 years' experience in a medical or social services office environment.Knowledge and use of computers.Experience with Electronic Health Records a plus.Excellent Typing skills.Excellent Data entry skills.Familiar with NYS Child Welfare anizational 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) fingerprintingNYS Justice Center Staff Exclusion List (SEL)NYS OMIG Medicaid Exclusion ListComplete mandated reporter trainingEducation:High school diploma - minimum; BA BS MPA preferredJob Type: Full-timeSalary: $35,000.00 - $38,000.00 per yearBenefits:Dental insuranceEmployee assistance programEmployee discountFlexible spending accountHealth insuranceHealth savings accountLife insurancePaid time offRetirement planTuition reimbursementVision insurance

Created: 2025-01-10