Medicaid Enrollment and Outreach Specialist I Job at University of Rochester (Rochester)

Job Description

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.

Job Responsibility

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
Benefit Management: 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
Referral Coordination: 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 and external agencies
Monitoring Caseload, Documentation, and Reports: monitor caseload and is responsible for accurate and timely documentation in requisite systems
Reviews productivity reports and prepares status updates as required by management
Problem Resolution: 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
Continuing Education: 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
Safety Precautions: 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

Requirements

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

Nice to have

Bachelor's degree
Foundational knowledge of public benefit rules and regulations
NY State of Health Certified Application Counselor

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Medicaid Enrollment and Outreach Specialist I

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