Job Abstract

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

JOB SUMMARY
The EVV (Electronic Visit Verification) Coordinator at Community Health Choice is experienced and detail oriented. The EVV Coordinator will be responsible for overseeing the implementation, maintenance, and optimization of the Electronic Visit Verification system within our organization. The primary focus of this role is to ensure compliance with regulatory requirements, facilitate staff training on EVV procedures, troubleshoot any issues related to EVV systems, and analyze data to identify areas for improvement. The EVV Coordinator will communicate with provider office staff to provide education and reiterate regulatory requirements for EVV to ensure compliance with HHSC. The ideal candidate will have a strong understanding of EVV technology, excellent communication skills, and the ability to collaborate effectively with internal stakeholders and external partners.

JOB SPECIFICATIONS AND CORE COMPETENCIES

• Manage EVV-related inquiries from external and internal parties:
• Manage the EVV system to ensure accurate and timely documentation of services provided.
• Implement audit and investigative strategies to identify potential issues and ensure compliance.
• Collaborate with internal stakeholders:
• Identify and address EVV-related issues.
• Take exported data from systems that do not interface with Community Health Choice systems.
• Ensure data integrity:
• Extract, process, analyze, and interpret data to identify trends, patterns, and issues related to EVV.
• Ensure timely and accurate submission of required reports and documentation:
• Maintain heavy contact with EVV Providers, including training, compliance, and other miscellaneous items.
• Provide training and guidance to providers:
• Ensure compliance with policies and procedures.
• Other duties as assigned.

QUALIFICATIONS:

• Education/Specialized Training/Licensure: High School Diploma required.
• Work Experience (Years and Area): Minimum of 3 years of experience in healthcare or a related field.
• Experience with healthcare data analysis tools, software, and/or platforms
• EVV proficiency with the ability to navigate the complexities of EVV systems
• Management Experience (Years and Area): N/A
• Software Proficiencies: - MS Excel and statistical reporting experience
• - SQL knowledge/Excel Macros

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!