Clinical Care Specialist

Arizona Department of Administration•Phoenix, AZ

1d•Onsite

About The Position

The Resource Liaison provides initial care management and coordination to caregivers of children and youth in out-of-home care statewide upon enrollment to the Arizona Department of Child Safety Comprehensive Health Plan (DCS CHP – formerly known as Comprehensive Medical and Dental Program).

Requirements

Familiarity with AHCCCS subcontractor standards, practices and compliance obligations
Understanding of pediatric medical terminology
Coordination of pediatric health care services
Clinical standards of care and quality of care
Understand Medicaid and Early Period Screening and Diagnostic Treatment (EPSDT) federal requirements
Excellent oral and written communication (in English).
Logical, critical-thinking and problem-solving.
Excellent time management skills
Intermediate use of computer software (example Microsoft Office Products including Excel)
Excellent interpersonal skills
Collaborative and team-oriented
Cultivate strong relationships with DCS CHP stakeholders and DCS staff in the field to facilitate meaningful two-way communication and education
Accurately document and account for information and impressions
Navigate the DCS Guardian system
Understand importance of and respect for the confidentiality of member information
Deal effectively with rapidly changing priorities and follow through on responsibilities
Must be able to secure and maintain clearance from DCS Central Registry.

Nice To Haves

Extensive customer service experience including but not limited to formal training and/or certification in medical and/or dental coding and terminology.

Responsibilities

Serves as primary health care liaison to foster caregivers and health care providers through outreach upon a child’s entry into DCS CHP enrollment providing education on health care delivery system, and services. Education may include but not limited to explanation of benefits, expectations of timely and appropriate scheduling of appointments visits for well child, dental and mental/behavioral health, and informational resources. Promotes and subject matter expert on Medicaid's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit available to assist with navigating the health care system.
Establishes relationships and partners with DCS field staff, DCS CHP staff, medical/behavioral health professionals, caregivers (kinship, foster parents, congregate care staff, etc.), clinic/hospital/specialty care providers and community resources to promote timely access to appropriate health services for the DCS CHP members.
Provides care coordination through use of technological portals, DCS' Guardian and Mercy Care's FamilyConnect, and access to shared care planning documents. Dictates and writes case notes, histories and narratives for use by DCS CHP clinical staff and DCS Specialists.
Participates on teams to identify and address systemic issues using the DCS Management System; participates with policy/procedure development and technical assistance tools. This position records, tracks and reports data related to care management/coordination including referrals made to community based resources including family/peer to peer support agencies/organizations.
Provides customer service regarding general medical, dental and behavioral health inquiries.
Other duties as assigned as related to the position.