Public Health & Prevention Specialist III
About The Position
The Medicaid and CHIP Services (MCS) department is driven by its mission to deliver quality, cost-effective services to Texans. This position makes a significant contribution to MCS’s mission by providing oversight to Managed Care Organizations, which deliver covered services, across delivery models, across all populations served by Medicaid and CHIP, and across all services available to individuals served by our programs. The Public Health & Prevention Specialist III performs moderately complex (journey-level) public health and prevention work related to coordinating the delivery of nonemergency medical transportation (NEMT) services, intake, tracking and resolution of client complaints, scheduling transportation services, quality review and monitoring of the delivery of client services in the newly created Fee For Service Delivery model. Work involves technical administrative support services in a customer care client services driven environment. Staff are responsible for scheduling transportation services and providing assistance to the contracted vendors and clients to ensure they receive NEMT services that are timely, appropriate, and delivered in a safe manner. Staff are responsible for receiving, researching and resolving complaints, reviewing service request calls to ensure quality of service and proper application of program rules and policies. Work is performed under general supervision with some latitude for independent judgment.
Requirements
- Graduation from high school or equivalent experience in customer service preferable.
- At least one (1) year of experience in a customer service environment.
- General knowledge of call center operations and functions
- Knowledge of program mission, goals and objectives
- Knowledge of State and Federal laws and agency rules, policies and procedures related to NEMT services
- Ability to effectively communicate, both orally and in writing
- Ability to collaborate in a professional manner with colleagues
- Demonstrate excellent interpersonal skills
- Knowledge of HIPAA rules and regulations and ability to demonstrate application with client information
- Demonstrates courteous, customer-friendly behavior
- Skill in researching topics and processing summary of findings
- Skill in performing data entry with a high level of accuracy and efficiency
- Ability to use personal computer and applicable programs and systems
Nice To Haves
- Spanish speaking preferred
Responsibilities
- Assist with the coordination and scheduling of NEMT services for clients that do not have any means to get from their residence to a covered healthcare service.
- Manage the service delivery request with the most cost-effective means of transport that also meets the clients' medical needs.
- Serve as the liaison between the contracted transportation providers, MTP administrative staff and MTP eligible clients.
- Provide guidance and direction regarding program policies and protocols and State and Federal laws to ensure consistent statewide application.
- Work closely with MTP's contract management staff to advise of anomalies in service requests, potential misuse or overuse of services that may warrant further examination and in the timely intake, review, assessment and disposition of client complaints.
- Participate in discussions with other MTP functional areas regarding pre and post monitoring reviews of the DRTS providers.
- Coordinate recipient service needs with medical providers, social workers and or other state agencies and accurately document information in the client's case notes.
- Participate in other assignments related to validation of transportation service claims and verification of an associated healthcare event, gathering data with respect to the provision of various NEMT services by DRTS providers, complaints trending and analysis, and statistical reports and assessments with respect to call quality and review of call recordings.
- Research and develop materials to educate contracted transportation providers on program details and assist with the analysis of data.
- Assist with the planning, organization and delivery of information, brochures and other publications to clients and stakeholders.
Benefits
- 100% paid employee health insurance for full-time eligible employees
- A defined benefit pension plan
- Generous time off benefits
- Numerous opportunities for career advancement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
