FIELD MONITOR

City of New York • New York, NY

6d • $48,206 - $55,437 • Onsite

About The Position

The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs for the City of New York. This role functions as a Field Monitor, responsible for overseeing the day-to-day operations of the New York Medicaid CHOICE Program in New York City, specifically monitoring MAXIMUS' operations. This includes monitoring HelpLine operations, outreach presentations, and analyzing data to ensure MAXIMUS meets contractual performance standards. HRA, through CMU, assists SDOH and CDOH in meeting monitoring objectives.

Requirements

• Applicant must be permanent in Caseworker Civil Service title.
• A baccalaureate degree from an accredited college or university accredited by regional, national, professional, or specialized agencies recognized as accrediting bodies by the U.S. Secretary of Education and by the Council for Higher Education Accreditation (CHEA).
• Fluent in Chinese Mandarin.

Responsibilities

• Conduct unannounced field visits to designated sites four days per week to observe presentations by Maximus and to ensure that all terms, conditions and deliverables agreed to in the Maximus contract are being met.
• Conduct on-site monitoring of Community Based Organization activity with regards to Maximus.
• Communicate any problems/issues identified through routine monitoring efforts that may be resolved and referred to the service provider.
• Monitor presentations that contain key messages regarding the basis of managed care, how to choose a plan, access to emergency services, self-referral, wrap around services, complaint procedure, exemption/exclusion procedures, member rights and responsibilities.
• Ensure that Medicaid beneficiaries are informed of all plan choices available.
• Ensure that Medicaid beneficiaries are referred to the toll-free helpline for answers to additional questions and problems.
• Monitor overall presentation quality including politeness and professionalism of counselors, assistance with the completion of enrollment forms, presentation and collection of evaluation forms which will be used for corrective action if warranted.
• Report findings of any gross violations of the Maximus Quality Assurance Plan to MAP’s Central Office within 24 hours to ensure immediate corrective action.
• Monitor Maximus Helpline performance and assist with the conduct of monthly audits to provide data regarding effectiveness of operation.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level