Managed Care Liaison - New York City Based (remote)

Qualifications

• Bachelor’s degree, preferably in Nursing/ or LMSW, LCSW
• Current unrestricted New York State RN license
• Current New York State Licensed SWCCM certification required, or successful completion of certification within 180 days of hire date as a condition of continued employment (Nursing only)
• 4 – 6+ years of relevant work experience, preferably with a healthcare provider
• 3 – 4+ years of clinical experience, including Medicaid experience
• Must have experience, expertise and knowledge of the child welfare system, foster care healthcare requirements, and the unique complex needs (including needs resultant of trauma) of this population
• Experience with Population Health Management
• Experience with managing people/processes in care management settings
• Strong organizing, prioritizing, and problem identification and solving skills
• Analytical skills; attention to detail
• Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences
• Proficient in MS Office (Word, Excel, PowerPoint, Outlook, Teams, SharePoint, etc.)
• Proven track record of successfully completing projects/tasks in alignment with overall strategies

Requirements

• Communicate relevant notification from LDSS coordinator when a member in foster care is enrolled in the managed care plan or when a current managed care member is entering foster care
• Serve as the direct Plan contact for coordinators and service providers, responsible for monitoring access for members in foster care
• Collaborate with LDSS coordinator to ensure assessments are completed on time
• Aid in care coordination if member is considered unstable by HCP or LDSS; or has a chronic condition
• Report to the LDSS foster care coordinator any change in member’s status (i.e., address, health status, etc.)
• Aid in discharge
• Collaborate with LDSS coordinator to ensure continuity of care plans are in place upon disenrollment or discharge from foster care
• Collaborate with LDSS coordinator to ensure that the LDSS and MCO (if plan transfer) are aware of the transition and current care plan can be coordinated
• Participate in the development of project plans; tracking and management of projects; and departmental activities related to foster care schedule and cost