Medicaid Managed Care Liaison
$52,000–$55,000 year
On-siteBrooklyn, New York, United States
Job Summary
Medicaid Managed Care Liaison in MercyFirst Brooklyn coordinates services, authorizations, and payments between youth, parents, contractors, health providers, agency administrators, Board of Trustees, and Managed Care Organizations to ensure needs of individual children are met and the agency remains fiscally viable. Responsibilities include establishing and maintaining direct communication with MCO Foster Care Liaisons and LDSS to coordinate enrollment, coordinating services through ongoing interactions between program providers and the Fiscal Department, ensuring current information and insurance cards are in the agency care management system (ASARA & AMD), investigating and resolving invoices, serving as primary contact with MCOs to ensure coverage and access to care, referring children/youth for needed services, coordinating with health care providers and school/community services, sharing plans of care, assisting with court-ordered services, facilitating single-case agreements when needed, discharge planning, notifying MCOs of status changes, ensuring continued eligibility, assisting with consent/confidentiality issues, and collaborating with the QI Director to ensure clinical notes are completed on time. The role requires a Bachelor’s degree or higher and a NYS Driver’s License, with experience in NYS child welfare, foster care healthcare requirements, and Medicaid Managed Care policies; duties also include developing and reporting Key Performance Indicators related to MMCL activities and coordinating with other IH staff. This is a full-time hybrid position located in Brooklyn, NY.
Required Qualifications
- A Bachelor’s Degree or higher in a related field plus a valid NYS Driver’s License with a satisfactory driving record. Related experience and knowledge of: NYS child welfare system; foster care healthcare requirements; unique/complex needs of the foster care population; and Medicaid Managed Car…
- Establishing and maintaining direct communication with MCO Foster Care Liaisons and the LDSS to coordinate enrollment when a child/youth is placed with the agency, including enrolling 8D babies born to youth in agency programs.
- Coordination of Services through ongoing interaction between agency program providers and the Fiscal Department.
- Ensuring current information and Insurance Cards are reflected in/uploaded to agency care management system (ASARA & AMD)
- Investigating and resolving invoices from care providers by identifying appropriate MCO or insurance plan and facilitating payment.
- Be the primary contact person to the MCOs to assist with ensuring coverage and access to care for the child/youth, including but not limited to:
- Informing the MCO of and coordinating access to immediately needed services;
- Referring children/youth for needed services and assist in provider selection.
- Responding to MCO and service provider communications
- Coordinating with health care providers, including school and community-based services.
- Sharing of plans of care and communicating significant changes in the child/youth’s health or functioning, need for additional required/recommended assessments.
- Assisting with court-ordered services.
- Facilitating single-case agreements if needed when a child/youth is placed outside the MCO’s service area.
- Discharge planning to ensure child/youth leaves care with coverage.
- Notifying the MCO of changes in residential status or foster care placement, absence from the agency, or other insurance coverage.
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