HUMAN SERVICES ANALYST - 64006339

Specific Responsibilities

• Serve as the key point of contact for all specialty care and support service referrals on behalf of clients made by subcontracted and providers and case managers.
• Telephone and in-person reception and direction of clients.
• New and re-enrollment client intake, eligibility determinations and eligibility verification.
• In instances of extended absences, vacancies or need for general coverage, assist with completion of needs assessments, plans of care, client linkage and referral to necessary services.
• Provide services in office and field visits.

Care Coordination

• Receive medical care and support service referrals via fax or hand delivery.
• Verify eligibility, insurance and whether referral request is HIV related.
• Coordinate the client’s attendance for appointments with referring provider, other care coordinators and assigned case manager.
• Process referrals within 30 business days from date of receipt.
• Document barriers for unmet care coordination timeline.
• Enter data on referral within electronic reporting databases including CAREWare, HMS and other data systems.

Ryan White Customer Service

• Serve as receptionist to the main case management office.
• Provide requested information to clients and service providers including eligibility verifications.
• Manage mail, fax and office supply distribution.

Ryan White Enrollment and Eligibility

• Process new and re-enrolling requests for client intake into Ryan White program services.
• Screens for insurance, medicaid and medicare eligibility utilizing required information systems Availity, Change Healthcare and others.
• Determine if client has access to or can obtain private health insurance and/or VA benefits.
• Request for enrollment and eligibility processed within 14 business days from date of referral or pre-enrollment screening.
• Document barriers for unmet enrollment time.
• Enter enrollment and eligibility case notes in CAREWare, HMS and other data systems.
• Network with other departments to assure smooth transition of services and continuity of care.

Administrative

• Participate in conference calls, planning meetings regarding Ryan White Patient Care and other departmental meetings.
• Complete DOH and Ryan White mandatory training in person and via webinars.
• Complete EARS/CSR, timesheets, program reports within required timeframes.
• Submit within required timeframes but not limited to cell phone verifications, travel documentation, invoices other required reports etc.

Other Duties

Perform other duties as assigned.

Qualifications

• 1 year of customer service experience.
• 1 year experience in patient registration and assessment.