• Personal Emergency Response System (PERS) Coordinator

    Job Locations US-NY-Staten Island
    ID 2018-1154
    Category
    Non-Clinical- MLTC
    Type
    Regular Full-Time
  • Overview

    Works in conjunction with Utilization Department to ensure delivery of high quality efficient services to all Extended MLTC members.

    Responsibilities

    • A liaison between the Nurse Care Manager, Enrollee and PERS vendors with all aspects of PERS coordination.
    • Coordinate with the Transitional department to create authorization for initial PERS placement and termination.
    • Review enrollee Service agreement for accuracy of service.
    • Provide information to PERS vendor as needed all approved for installation.
    • Coordinate timely approved placement and removal of PERS units with Vendors.
    • Inform Care Management Department in a timely fashion of all delays in PERS placement.
    • Notify the Care Management department of emergency report received from PERS Vendors.
    • Processes service authorizations as requested by Nurse Care Managers, and communicates approvals to servicing providers.
    • Keep a running Log of continued authorization of PERS.
    • Documents all activities/interventions in appropriate database (HMA, McKesson).
    • Assists with scanning, printing, filing, and other administrative tasks as needed.
    • Assists with Maximus warm transfer calls.
    • Assists with all translation needs as needed (members, potential enrollees, Enrollment RNs, pre-enrollment screening, etc.).
    • Assists with training of new staff.
    • Demonstrates sound judgment by taking appropriate actions regarding suspected violation of corporate compliance regulations.
    • Reports all suspected violations to Supervisor, Compliance Officer or Compliance Hotline.
    • Participates in special projects or other duties as assigned.
    • All other tasks assigned by the management team.
    • Travels to other Extended office locations as needed.

    Qualifications

    • High school diploma or GED required
    • Basic computer skills (Microsoft Word, Excel, etc) required
    • Basic knowledge of CPT codes medical terminology preferred
    • Previous experience in Managed Care industry preferred
    • Good communication and organizational skills.

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