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Northern Rivers Family  Services
  • Full Time
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  • Alba, NY
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Managed Care Liaison

Job Details

Job Location: Albany-Academy Main-NPCS - Albany, NY
Position Type: Full Time
Education Level: High School/GED
Salary Range: Undisclosed
Travel Percentage: Up to 50%
Job Shift: Day

POSITION OVERVIEW

Managed Care Liaison

Northern Rivers is seeking a Managed Care Liaison specializing in Medicaid enrollment and billing. In this role, 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 Duties 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
  • Knowledge 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 skills are very important as this position 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 Experience:

  • Managed Care Liaison delineation:
    • Liaison 1: Associates degree plus a minimum of three years' experience
    • Liaison 2: Bachelor's Degree plus a minimum of two years' experience
  • Experience 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


If you want a rewarding career where you make a positive impact on children and their families, we want to talk to you! At Northern Rivers Family of Services, we work together to make a difference in our client's lives while also strengthening our community.
We are a family of human service agencies united in our passion to helping children, families, and adults reach their potential. Northern Rivers coordinates the quality of care, depth of programs, and combined size and passion for the mission to provide care for more than 18,000 people each year in 41 counties throughout New York State. If you’ve got the talent, drive and desire to make a real difference in your community, you need to be a part of Northern Rivers Family of Services!
Our employees receive generous paid time off, an expansive health care package, tuition reimbursement, loan repayment assistance, free training/CEU opportunities, and much more!
Apply today to become part of our team!
Northern Rivers is an Equal Opportunity Employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status, or any other characteristic protected under applicable law. We cherish the unique contributions of our diverse staff, and are building a culture where everyone has the opportunity to do the meaningful work here at Northern Rivers!