Field Monitor

City of New York • Brooklyn, NY

2d

About The Position

APPLICANT MUST BE PERMANENT IN CASEWORKER CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE. The Medical Assistance Program (MAP) administers Medicaid and related public health insurance programs, for the City of New York. Applying individuals and families are approved for eligibility against applicable Federal and State guidelines. Those found to be eligible can use coverage provided to access doctors, medication and other health care services at little or no cost. CMU is responsible for monitoring MAXIMUS’ day-to-day Operation of the New York Medicaid CHOICE Program in New York City. This responsibility includes but is not limited to monitoring the HelpLine operations and Outreach presentations. Monitoring also includes the analysis of data reported by MAXIMUS and an evaluation of whether or not MAXIMUS is meeting the performance standards identified in their contract. HRA through CMU assists SDOH and CDOH in meeting monitoring objectives through the following actions: The Medical Assistance Program (MAP)/Managed Care Contract Monitoring Unit is recruiting for one (1) Caseworker to function as a Field Monitor who will:
- 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.

Requirements

• APPLICANT MUST BE PERMANENT IN CASEWORKER CIVIL SERVICE TITLE OR BE PERMANENT IN A COMPARABLE TITLE ELIGIBLE FOR 6.1.9 TITLE CHANGE.
• 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).

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: Entry Level