Job Abstract

Provides support to prospective members, members and their families including community resource planning, advocacy, skill building, linking patient/families to community resources and providing assistance with entitlements. Works closely with client, support system and/or family to obtain Medicaid and connect client to appropriate MLTC in the community. Works under close supervision.

$23.17 - $28.96 Hourly

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays  
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability   
• Employer-matched retirement saving funds  
• Personal and financial wellness programs?  
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care??  
• Generous tuition reimbursement for qualifying degrees  
• Opportunities for professional growth and career advancement?  
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities??  
• Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.

What You Will Do

• Performs outreach to community agencies in order to establish working relationships and provides access to other services. Advises other agencies of the program and referral process.
• Works closely with client, support system and/or family to obtain Medicaid and connects client to appropriate MLTC in the community. Conducts face-to-face encounters with members to aid assessment process, as needed.
• Screens financial records of clients/families to assist in assessment of enrollment eligibility.
• Contacts the appropriate program staff to recommend third party reimbursement, entitlements and community resources for clients/families to ensure that they have access to the adequate entitlement benefits.
• Maintains records and statistics in accordance with program requirements. Documents services planned and provided; maintains written and verbal communication records according to VNS Health policies.
• Participates in clinical team meetings; works collaboratively with other VNS Health Plans staff to ensure that prospective members/ members have appropriate Medicaid eligibility and receive appropriate MLTC services.
• Arranges transportation and/or appointments for members to relevant offices/ sites, as needed.
• Attends in-service education programs and other training as required by VNS Health and funding sources.
• Assumes responsibility for continued professional growth.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:

• Valid driver’s license may be required, as determined by operational needs.

Education:

• Associate's Degree in a relevant field, or the equivalent combination of education and work experience, required

Work Experience:

• Minimum of two years’ work experience in a health care or human services setting, required
• Knowledge of Medicaid eligibility and Medicaid Managed Care regulations, preferred
• Bilingual in Chinese & English
• Position may require travel between regions.