This PFR position is responsible for reviewing and processing all Escalated Issues that arise statewide for SPPC Members. The PFR contacts the member and provider agency when investigating reported issues to identify factors that may be a barrier to continued services. Contacts made and facts found are documented to provide tracking, coordination of services, and/or referrals to other entities. The PFR enters collected data into the electronic system for agency compliance and administrative reports. Assists with revisions/updates to processes, reports, and documents, along with providing training to pertinent staff. The PFR prepares and presents cases to the Ethics of Care Committee (EOCC), as applicable, and coordinates with MSU-AA when issues arise that include or affect Advantage members. The PFR works closely with Adult Protective Services, Child Care Services, and the Office of Client Advocacy when issues arise that may include abuse, neglect, and/or exploitation. This position also manages the Interpreter services when an applicant/member isn't able to communicate with others necessary in collecting data and providing needed services by working closely with CAP Contract Services. The PFR is the administrator over the RMS, notifying nurses and nurse supervisors so that data is collected and confirmed prior to the request expiring. This position requires reliable and stable home Internet connectivity (not a hotspot) for working in a remote setting. Occasional travel may be required, and must have the ability to lift up to 15 lbs. for transporting a computer. Ability to work on a diverse team and directly with people from diverse backgrounds, specifically racial, ethnic, socioeconomic, and disability.
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Job Type
Full-time
Career Level
Mid Level