Professional, who assesses psychosocial status, interprets the social and emotional factor related to health problems and provided counseling, referral to community resources and crisis interventions in addition to assisting with discharge planning.
The UAS Review Nurse will review clinical documentation to monitor timeliness and ensure accuracy and compliance with the Plan's policies and regulatory data integrity standards and requirements including contractual obligations with State and Federal agencies such as NYDOH, LDSS and CMS.
Pre-screens all potential enrollee’s eligibility for MLTC services and ensures all pre-enrollment criteria are met prior to scheduling visit. Collaborates with Medicaid Specialist as needed to assist with consumer’s Medicaid eligibility.
The Medicaid Specialist will be responsible for providing assistance to current and prospective members of Extended Managed Long Term Care. The Medicaid Specialist works with members assisting in the Medicaid application process, recertification, eligibility issues; which requires extensive knowledge of current regulations, policies, and protocols governing eligibility for obtaining and retaining Medicaid.
UAS-NY Review associate will provide general support to the UAS-NY Review team. Responsible for accurate and timely data entry and electronic file maintenance.
Coordinator will be responsible for assisting in the transitional process to accommodate an efficient and timely start of care for perspective enrollees through the said responsibilities below. The Transitional Liaison Coordinator will receive and get guidance from the Transitional Team Leader.
Representative will be responsible for ensuring excellent and efficient customer service, ensuring that all covered services are authorized and placed in a timely manner, as well as provide support for all functions of the Extended MLTC as required.
Pre-screens all potential enrollee’s eligibility for MLTC services and ensures all pre-enrollment criteria are met prior to scheduling visit. Collaborates with Medicaid Specialist as needed to assist with consumer’s Medicaid eligibility.
RN Care Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate long-term care services for Extended MLTC members through assessment and member-centered care planning, direct provider coordination and collaboration to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes.
