Offer: Managed Care Liaison
Managed Care Liaison
POSITION OVERVIEW
Managed Care LiaisonNorthern Rivers is seeking a Managed Care Liaison specializing in Medicaid enrollment and billing. In this function, you would review and verify Medicaid managed care enrollment and eligibility for our clients, review for accuracy and timeliness the documentation for the billing of Medicaid per diem, as well as evaluate authorizations and documentation for referrals, procedures, CFTSS services and HCBS respite.
Essential tasks and Responsibilities of a Managed Care Liaison:
»Coordinate with the LDSS liaison and the managed care company liaison to ensure that children in foster care receive appropriate health and behavioral health care.
»Provide communication between program, county, finance and managed care companies in the following areas:
»Medicaid coverage during placement and at discharge
»Primary Care Provider changes
»Managed care enrollment and disenrollment
»Obtaining notices from the Managed Care Plans
»Access to health services
»Changes in foster care placements
»Billing issues
»Consent and Confidentiality issues
»Court orders
» expertise of New York State health coverage options.
»Ensure that children have access to needed services and know the managed care plans prior authorization requirements.
»Ensure that services on treatment plan are being carried out and documented correctly.
»Be a point of contact and resource to the program, finance and managed care company around billing, (i.e., is child eligible, did billing occur, were we paid, if not why?)
»Ensure that releases are properly filled out and that consents and confidentiality are kept for all medical and behavioral health needs.
»Work requires 25-50% community travel/visits to client homes.
»Effective communication and organizational expertise are very important as this job offer ensures that services on treatment plans are being carried out and documented correctly in order for clients to receive appropriate health care needs.
Your Education and practice:
»Managed Care Liaison delineation:
»Liaison 1: Associates degree plus a minimum of three years' practice
»Liaison 2: Bachelor's Degree plus a minimum of two years' practice
» practice in a specialized area or technical field (such as Residential Care, Child Care, Food Service, Nursing, Accounting) in regards to Medicaid billing a plus.
»Computer/database literate in a Windows environment.
ABOUT NORTHERN RIVERS
Recommended Jobs
Territory Business Manager (Queens, NY, US, 11365)
Territory Business Manager (Queens, NY, US, 11365) Job Title: Territory Business Manager - Allergy Infant Formula - Queens, NY We are Reckitt Home to the world's best loved and trusted hygie…
Head of Marketing - Veeva Quality
Veeva Systems is a mission-driven organization and pioneer in industry cloud, helping life sciences companies bring therapies to patients faster. As one of the fastest-growing SaaS companies in histo…
Auto Repair Shop Manager/Service Writer
Key Responsibilities: Customer Service & Sales: Greet customers and listen to vehicle concerns Create repair orders and explain services clearly Provide repair estimates and get customer ap…
Job Opportunity: Counter Sales Associate
Counter Sales Associate Our client in Red Hook is seeking a Counter Sales Associate with sales, administrative and customer service practice who also has expertise of HVAC/plumbing and accessories.…
Plant Electrician
We are currently looking for an Electrician to join our growing team at our Saratoga, NY location. This position is a Monday-Friday, 8am-4:30pm schedule. Our Electricians are responsible for start-…
Senior Software Engineer, Backend (Affirm Card)
Affirm is reinventing credit to make it more honest and friendly, giving consumers the flexibility to buy now and pay later without any hidden fees or compounding interest. The Affirm Card Enginee…
Manager, Global Social Media & Innovation
Michael Kors is always interested in hearing from talented, globally-minded individuals with a passion for fashion. If you enjoy working in a creative, fast-paced environment, then we would love t…
Software Engineer (AI Tooling)
Garda Capital Partners (Garda) is a multi-billion dollar alternative investment firm with over 22 years of experience deploying relative value strategies across fixed income markets for institutional…
Line Attendant - 2nd Shift
Starting Pay: $17.75 per hour Shift: 2nd Shift Hours: 11:30AM - 8:30PM What We Offer: ~ Weekly Friday pay ~ Earn up to 2 weeks paid time off your first year ~7 paid holidays and 2…
Power BI Developer
Power BI Developer Employment Type: Full-Time, Mid-level Department: Information Technology CGS is seeking a Power BI Developer to join our team in supporting a wide-ranging technical supp…