Medicaid Enroll&Outrch Spc I

University of Rochester•City of Rochester, NY

11d•$24 - $30

About The Position

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Requirements

Bachelor's degree (preferred)
Limited experience with Medicaid programs.
Possess 1-2 years of experience in case management or related field or equivalent combination of education and experience
Or equivalent combination of education and experience
Must provide and maintain a valid NYS Class 5 driver’s License

Nice To Haves

Foundational knowledge of public benefit rules and regulations. (preferred)
Demonstrates professionalism, motivation, and strong communication (written and verbal).
Possesses customer service skills and the ability to work independently and solve problems in an interdisciplinary team.
NY State of Health Certified Application Counselor (preferred)

Responsibilities

Counsels, guides, advises and provides outreach services to patients requiring public benefits including Medicaid, Child Health Plus, NYS Marketplace Exchange or other public entitlements.
Accountable for coordinating all activities and necessary documentation needed to secure appropriate benefits.
Resolves complex problems related to this process.
Shares expert public benefits knowledge by providing consultation to physicians, social workers and other Health System staff whose patients require benefit assistance for payment and discharge planning.
MEOS I apply for benefits via computer systems and/or paper application and may accompany or represent the patient at eligibility interviews, case conferences or fair hearings.
Provides application assistance to patients referred by University of Rochester Health System staff through face-to-face interaction, telephone contact and home visitation for patients requiring assistance.
Responsible for assessing referrals to determine eligibility for potential benefits and develops a plan of action to secure each.
Communicates, coordinates and develops professional relationships with internal departments: Health Insurance Counseling, Social Work, Patient Financial Services, Financial Assistance Program, RIM, Office of Counsel and Clinicians.
External coordination includes families, community physicians, Department of Social Services, Social Security, Veterans’ Administration, Homeland Security, advocacy groups and other agencies.
MEOS I monitor caseload and is responsible for accurate and timely documentation in requisite systems: Financial Assistance Module (FAM), EPIC, NY State of Health (NYSOH) On-Line Portal and OnBase scanning.
Reviews productivity reports and prepares status updates as required by management.
Identifies barriers to securing public benefits which may impact hospital reimbursement and timely discharge.
Consults with MEOS II, MEOS Supervisor or Manager/Assistant Director to develop, coordinate and implement plans to successfully resolve barriers.
Exercises a moderate level of problem solving ability.
Gathers and interprets data to address eligibility and case related issues.
Applies independent judgment in routine situations, seeking guidance for more complex problems.
Attends seminars and reviews Federal and N.Y. State regulations, UR Medicine mandatory training requirements, NYSOH Marketplace Certified Application Counselor Seminars and literature to maintain expert knowledge of public benefit programs.
Exercises professional judgment to determine whether a home visit is a safety risk.
Keeps direct supervisor advised of planned visits and takes appropriate safety precautions.
Operates a motor vehicle for outreach purposes.
Ensures all safety precautions are taken during vehicle operation.
Adheres to safety precautions involving mask, gown and glove usage.
Other duties as assigned