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Enrollment Specialist

Company: Volunteers of America
Location: Montrose
Posted on: April 3, 2021

Job Description:

Job Description We Are Inspired to Serve. Join us at PACE! Making a difference in the lives of others - that's what working at Volunteers of America is all about. Our employees have the opportunity each and every day to make a difference in the lives of older adults. From improving our residents' quality of life, to creating peace of mind for them and their families, our team members know that as a part of our community, they are changing lives. FULL-TIME HOURS Standard work hours are a 8 am to 5 pm, 40 hours a week. WAGE: $42,518 - 46,200 Insurance Benefits offered: Retirement Medical (30 hours or more a week) Benefits available when hired to work 24 or more hours a week: Dental Vision Legal Life Accident Critical Illness Short-Term Disabilities ID Theft Loan Program OBJECTIVE: Under the supervision of the Center Director obtains initial information relating to admissions, coordinates intake process, and provides information and referrals to community agencies as appropriate. Promotes the Senior CommUnity Care (SCC) Program to potential participants and community agencies. Onboards Participants into the SCC Program. Essential Functions:

  • Gather necessary documentation and application requirements in working with participants for Medicaid approval; Assists with financial eligibility process for participants.
  • Ensures compliance with all State Medicaid Rules and Regulations that pertain to Medicaid, Straight Medicaid, LTC, Spousal Impoverishment and Trusts, Food Stamps, Old Age Pension (OAP) and other Medicaid programs for which participants may be eligible.
  • Tracking private pay clients and instrumental in obtaining a smooth transition to Medicaid eligibility.
  • Guides participants through financial eligibility and enrollment process.
  • Interpret program regulations and other pertinent material to applicants, recipients, and the general public.
  • Receives and provides information to referrals to the SCC Program; refers individuals to other appropriate resources as indicated.
  • Assesses potential participants in home, nursing homes, hospitals or other settings.
  • Maintains current, written assessment and intake records inclusive of potential participant's expressed wishes and the referral services provided, as appropriate.
  • Assists potential participants in managing their needs while undergoing intake and assessment process, including referrals to doctors and other community agencies.
  • Acts as Navigator for new participants for the first 45 days of a participant's enrollment to ensure SCC Program onboarding and information is provided to assist in the transition for participants.
  • Participates in Interdisciplinary Team meetings when potential enrollees are assessed for enrollment into the program for purposes of providing and clarifying information obtained during the intake assessment.
  • Provides alternative community resources to applicants who are not accepted into the program.
  • Is responsible for reviewing participant's rights and responsibilities and assuring that the participant and/or authorized representative understand these rights.
  • Reviews Medicaid eligibility, monitors time frame for re-certification and facilitates Medicaid applications for certification and re-certification.
  • Collects data and prepares reports in accordance with Centers for Medicare and Medicaid Services (CMS) requirements or program requirements.
  • Assists in evaluating the intake and assessment process, identifying problem areas accordingly and making changes as recommended.
  • Contacts identified key referral sources regularly to discuss possible program candidates.
  • Maintain ongoing relationships with identified individuals and agencies to ensure a clear understanding of the program as a vital community resource.
  • Maintain a focus on meeting the needs of internal and external customers; develop and maintain effective relationships with others; relate well to people from varied backgrounds and in different situations; show understanding, courtesy, tact, empathy, concern, and politeness.
  • Participants and supports the Quality Improvement Initiatives.
  • Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants and families.
  • Performs related duties as required or requested Job Requirements QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Must have medical clearance for communicable diseases and up-to-date immunizations before having direct participant contact. Must have a valid driver's license, clean driving record, proof of insurance and have means of transportation.
  • Education: Bachelor's Degree in humanities, health and human services field with experience sales/customer service/social work.
  • Experience: Two (2) years of experience in marketing, with more emphasis on sales, and/or admissions role for a health care provider, or in an information and referral resource role within the senior networks. Shall have either training or related experience in the job assigned. Must have a minimum of one year of experience in working with the frail or elderly population.
  • Knowledge, Skills and Abilities:
    • Ability to effectively present PACE philosophy and model to the community and to prospective participants.
    • Working knowledge of physical, psychosocial, behavioral, and family needs of the elderly.
    • Working knowledge of the Montrose and Delta counties communities' health and social service delivery systems, and aging network.
    • Effective written and verbal communication skills; Ability to keep accurate and detailed records and data.
    • Ability to learn, comprehend and stay current of Medicaid system.
    • Able to assess potential participant's financial status.
    • General knowledge of financing mechanisms such as Medicaid, Medicare, Prospective Payment Systems and Health Maintenance Organization/ Managed Care providing risk-based capitated systems.
    • Good working knowledge of PACE philosophy and eligibility/denial criteria.
    • Ability to work under pressure of monthly deadlines; to be able to remain focused while gathering last minute information, appointments, information for Medicaid, IDT and families in order to meet enrollment goals.
    • Ability to utilize computers and other electronic devices for tasks such as timekeeping, in-servicing and documentation in the Electronic Health Record (EHR) and other electronic records. EOE M/F/Vets/Disabled

Keywords: Volunteers of America, Snowmass , Enrollment Specialist, Other , Montrose, Colorado

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