OverviewInitiates the referral and enrollment process for VNS health plan services to achieve desired enrollment goals. Performs outreach to assess eligibility and troubleshoot inquiries related to enrollment issues. Works under general supervision.Compensation Range:$20.98 - $26.23 HourlyWhat 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
What You Will Do
Provides consumers education on VNS Health plans benefits and eligibility requirements. Reviews and confirms potential enrollees eligibility; collaborates with New York Medicaid Choice (NYMC) in scheduling New York Independent Assessor (NYIA) assessments, including follow up to obtain CFEEC scheduled dates and outcomes as needed.
Offers assignment of Medicare assistance as needed.
Responds to inquiries regarding pre-enrollment issues, eligibility and program information to ensure service satisfaction. Works with our internal and external customers to ensure referrals are processed and followed up in a timely manner.
Participates in outreach to potential enrollees referred via our referral inbox and/or fax. Reviews their eligibility and transfers them to the appropriate program. Schedules the NYIA assessments follow up as needed to obtain NYIA scheduled assessment dates and outcomes as needed.
Processes daily submissions received internally for enrollment to Maximus via the portal. Maintains member record system with new employee enrollment documents.
Works collaboratively with various departments and vendors to ensure consumers are enrolled in a timely matter.
Ensures Auto (State mandatory) enrolled members are uploaded to Share Point for vendor assignment.
Prepares monthly enrollment report for new enrollees start of care authorizations and care manager assignment.
Assists in the monitoring and updating of our Health Commerce System case list.
Provides education on CDPAS process and requirements for members interested in receiving CDPAS services.
Provides outreach to new enrollees and current members and their PCPs to obtain new or recertification MD Orders for continued CDPAS services.
Maintains and documents actions taken in our CDPAS membership tracking database and upload completed CDPAS Acknowledgment forms and MD Orders.
Receives and processes daily Care Management (CM) and Utilization Management (UM) Activities request for vendor assignment. Creates activities for follow up as needed.
Schedules SCIC and assessment request received via Share Point for Select Health members.
Conducts daily outreach to potential enrollees to confirm acceptance of hours offered and completion of 3-way transfers calls with the potential enrollee and NYMC prior to the deadline.
Participates in special projects and performs other duties as assigned.
QualificationsLicenses and Certifications:
Valid NYS driver’s license or NYS non-driver’s ID, required
Education:
Associate's Degree in health, human services, other related discipline or the equivalent work experience, required
Work Experience:
Minimum two years experience in customer service, required
Proficient interpersonal, organizational, strong attention to detail, analytical and writing skills, required
Knowledge of Medicaid eligibility requirements, required
Proficiency with personal computers, including MS Excel, Word and Outlook, preferred
Prior experience in Call Center setting, preferred
CAREERS AT VNS HealthThe future of care begins with you. Together, we will revolutionize health care in the home and community. When you join VNS Health, you become a part of something bigger. For generations, we’ve been a recognized leader and innovator in patient-centered and community-focused health care. At VNS Health, you’ll have the opportunity to meaningfully impact lives. Including yours. Discover your next role at VNS Health.
