Job Abstract

The Managed Long Term Services and Supports Coordinator II is responsible for the Managed Long Term Services and Supports  (MLTSS) Outreach to members accessing assistance for unmet needs and barriers in care. This position handles questions and resolves issues. This position provides members and others with basic information about core and other MLTSS administered services and commonly requested information.  This position collaborates with other L.A. Care departments, internal and external stakeholders, and serves as  a resource in the implementation of  new programs, initiatives and educational materials related to MLTSS administered services. Provides critical administrative support to clinical team in order for nurses to focus on clinical functions with Utilization Management (UM) and care coordination. Clinical areas supported include but not limited to: Community Based Adult Services(CBAS), Skilled Nursing Facility (SNF), and Palliative Care. This position assists the L.A. Care cross functional departments and L.A. Care's contracted Provider Network in understanding MLTSS programs to ensure members, families, and caregivers have access to a service delivery system that improves the well-being of our members while giving them an opportunity to remain living safely in their homes. MLTSS consists of core services (In-Home Supportive Services (IHSS), Multipurpose Senior Services Program (MSSP), Long Term Care (LTC), Community Based Adult Services (CBAS) and other MLTSS administered services such as CalAIM (Community Supports, Population Health, Benefit standardization) and Palliative Care.

Outreaches to members identified via various methodologies for unmet needs or barriers in care. Provides general information about MLTSS and MLTSS administered services.  Provides information on available benefits and coordinates services by making appropriate referrals to MLTSS and  internal programs, community resources and coordinating care with member’s Preferred Provider Group/ Primary Care Physician (PCP) when services are put in place. 

Handles first level calls involving member eligibility verification, general program and administration questions, benefits and services, and triaging of calls to appropriate units within and outside of MLTSS.

Responsible for Long Term Care (LTC) Institutional Member reassignment for member residing in LTC and for members who transition to the community, including processing of LTC discharge summaries assigning member back to a community PPG. 

Acts as a resource in community programs, MLTSS (IHSS, MSSP, CBAS, LTC), CalAIM and Dual Special Needs Plan (DSNP) services and benefits.

Assists with institutional placement, member transitioning to the community, medical records gathering, and facility/center decertification and closures.

Perform other duties as assigned.
 

Required:
At least 0-1 years related experience, preferably managed care, Medi-Cal, Managed Long Term Services & Supports, and knowledge of medical terminology.

Required:
Strong verbal & written communication skills. 

Strong organizational, prioritizing, time management and interpersonal skills, along with sound judgment.

Must be a strong team player, punctual, and has excellent attendance record. 

Must be a quick learner, excellent team player and customer service oriented.

Ability to answer a high volume of calls and referrals.

Knowledge of medical terminology. 

Proficiency with Microsoft Word & Excel.
 
 
Preferred:
Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.