Health Home
The Management Information Specialist facilitate access to information regarding all operational data needed for member records including care plans, enrollment data, consent forms, billing data and authorizations and supports reporting and tracking of data for the organization and the regulatory agency to assure compliance and quality outcomes.
ESSENTIAL RESPONSIBILITIES:
Activities include but are not limited to the following:
• Ensure compliance with all pertinent government and agency regulations and operating standards, including maintaining all required documentation and applicable databases.
• Receive electronic files from DOH and transfers to Evolv system within specified time period.
• Prepare daily, weekly, monthly reports to track status (consents, member status, outreach, enrollment discharge)
• Prepare reports (outreach, engagement, Fact GP, qualification of services, active enrollment, care plan & update status, type of care management, how many services & type, assessment state, waiver, intensity, closed/reopen status) for quarterly DOH report
• Receive, document community referrals and assign to appropriate agency, including SPOA referrals.
• Receive consents and changes to consents from all care management entities. Establish processes within network providers for access to care plan with read only. When changes occur with consents then would need to revoke access. (tbd).
• Prepares mailings to members as needed.
• Care Management to assigned cases.
• Other duties as requested.
Requirements
• Proficient Computer Skills
• This position may have regular and substantial unsupervised or unrestricted physical contact with individuals receiving services and is required by law to be fingerprinted for a criminal history record check under OPWDD (Office for People with Developmental Disabilities) or OMH (Office of Mental Health).
• Must have a valid NYS Driver’s License
• Must possess the ability to make independent decisions when circumstances are warranted.
• Experience with or knowledge of NYS health insurance programs (e.g., Medicaid, Managed Care), Preferred.
• Prior experience with conducting, analyzing or tracking data
• Proficient in the use of standard office technology and basic Microsoft applications, including Excel, Access, Outlook, Word
• Strong written and verbal communication skills
• Capable of working both independently and as a member of a team
• Experience with developing spreadsheets or other tracking systems to monitor and evaluate project results and progress
• Associate’s degree in a related field from accredited college
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