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Managed Care Liaison

Job Details

Job Location

Albany-Academy Main-NPCS - Albany, NY

Position Type

Full Time

Education Level

High School/GED

Salary Range

$23.00 - $23.25 Hourly

Travel Percentage

Up to 50%

Job Shift

Day

Job Category

Nonprofit - Social Services

Description

Managed Care liaison

As a Managed Care Liaison, you will support the Residential and Foster Care teams in ensuring that children placed in Northern Rivers are enrolled and have access to medical and mental services. The Managed Care Liaison will report to the Coordinator in supporting the program. You will work onsite with the ability to work remotely when approved by Coordinator.

Responsibilities:

+ Coordinate with the managed care company liaison to ensure that children in foster care receive appropriate health and behavioral health care.

+ Provide communication between the program, billing administrator, and managed care companies in the following areas:

+ Medicaid coverage during placement and at discharge

+ Primary Care Provider changes

+ Managed care enrollment and disenrollment

+ Obtain notices from the Managed Care Plans

+ Access to health services

+ Changes in foster care placements

+ Billing issues

+ Maintain knowledge of New York State health coverage options

+ Ensure that children have access to needed services and know the managed care plan's prior authorization requirements

+ Ensure that services on the treatment plans are completed and updated promptly

+ Be a contact and resource to the program, Billing administrator, and managed care company to answer questions about eligibility, types of benefits, and approval processes.

+ Ensure documentation is available and sent between the agency and Managed Care Organization.

+ Process mail, including distributing and mailing out all Client ID cards when received.

Requirements and Education:

+ High School Degree Required

+ 3 years of experience working with medical insurance required

+ Valid NY Driver's license required

Benefits

+ Health care package: medical, dental, and vision

+ Tuition reimbursement

+ Paid time off

+ Holiday Pay

+ 401 (K) plan

+ Life Insurance

+ Loan repayment assistance

+ Free training/CEU opportunities

Northern Rivers Family of Services is an Equal Opportunity Employer. All applicants will be considered for employment without attention to race, color, religion, sex, orientation, gender identity, national origin, veteran or disability status, or any other characteristic protected under applicable law. We cherish the unique contributions of our diverse staff and are building a culture where everyone has the opportunity to do the meaningful work.

Northern Rivers Family Services is committed to keeping a safe and healthy working environment for all employees and the clients we serve. As an employee of Northern Rivers Family Services, you will be expected to perform your job in the safest possible manner and to acknowledge that safety is an important part of everyday performance. As an employee of Northern Rivers Family Services, you will adhere to all safety procedures and take part in safety program activities.

Employer’s Disclaimer

All requirements are subject to possible modification to accommodate individuals with disabilities reasonably.

This job description in no way states or implies that these are the only duties to be performed by the employee occupying this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by their supervisor. Furthermore, the agency reserves the right to add or revise an employee's job duties at any time at its sole discretion.