Builds relationships, receives referrals and reviews potential member information referred to VNS Health. Determines initial appropriateness of admission. Promotes and fosters ongoing collaborative communication with institutional and VNS Health personnel to establish coordinated home care. Facilitates the safe and timely transfer of potential members from a hospital, skilled nursing facility, or other community-based organization to the care of VNS Health. Works under moderate supervision.

$23.17 - $28.96 Hourly

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
• Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals.

What You Will Do

• Obtains and processes referrals to a network of contracted Managed Long Term Care (MLTC) plans.
• Obtains and confirms demographic and other medical and social member information.
• Works within intake related electronic platforms to gather proper information to generate a new member referral and ensures accurate documentation.
• Facilitates the potential member during the time frame before they become eligible for community Medicaid.
• Coordinates the effective date of community Medicaid and the eligibility deadlines for member enrollment in a health plan.
• Determines member needs and provides accurate and responsive intake to ensure member satisfaction. Provides appropriate handoff of information to team members to support a safe and effective transition of care.
• Participates in special projects and performs other duties as assigned.

Education:

• High School Diploma required
• Associate's Degree strongly preferred

Work Experience:

• Minimum two years in direct community outreach/sales/business development required
• Prior experience in a Licensed Home Care Agency preferred
• Knowledge of Managed Long Term Care and NYS Department of Health regulations and required forms (M11Q, Independent Assessor) preferred
• Understands the authorization process and ability to follow up on authorizations preferred
• Knowledge of the Community Medicaid process, including eligibility for managed long term care and the relevant coverage codes set by NYS MMIS preferred