Child Health Care Cooridnator bei Children's Network of Hillsborough

Description

Mission Statement

The Children’s Network of Hillsborough County is committed to working with the community to protect children and preserve families.

 

General Purpose of Job

This is supervised work in the Children’s Network of HC’s Revenue Maximization Unit and is responsible for coordinating the enrollment process for children to receive behavioral and medical health services through the Medicaid Managed Care Plan in a timely manner. These responsibilities require the employee to communicate and liaison with case managers, clients, and the Nurse Care Coordinators to support and assist the client in enrolment Medicaid coverage and receive appropriate services. The Child Health Care Coordinator must be able to acquire skills to use the FSFN (Florida Safe Family Network), FLORIDA, FMMIS system and gain familiarity of Chapter 39 of the Florida Statutes.

 

QUALIFICATIONS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Essential Duties and Responsibilities

• Assist case managers, foster parents, and caregivers with Medicaid questions or issues of access to Medicaid services.
• Responsible for ensuring there is no lapse in coverage from notices provided by AHCA. If lapse in coverage must work in a timely manner to advise enrollment specialists so that benefits may be reinstated.
• Review shelter removal dockets and complete initial CIC Medicaid application.
• Review and maintain all Medicaid and medical related correspondence. Review medical bills and research coverage before forwarding to Utilization Management Unit.
• Complete necessary Primary Care Physician (PCP) changes to ensure children receive appropriate medical care. Must also communicate with medical offices to coordinate timely appointments, as necessary.
• Collaborates with the Sunshine Program Manager to address and resolve issues related to TPL.PCP changes, system functionality and other Sunshine-specific concerns.
• Coordinate distribution of all member ID cards, handbook or other notifications to case managers as received by the Lead Agency.
• Maintain relationships with insurance company representatives and provide necessary documents for change requests.
• Facilitates insurance card retrieval by contacting providers when necessary and coordinating with the Records Department to arrange pickup times.
• Training: Attends and successfully completes all mandated training courses within the probationary period, and as scheduled thereafter.
• Other duties may be assigned as special projects may be requested.

 

Working HOurs

CNHC’s believes in work life balance for all employees. This is an in-office position, Monday-Friday from 8:00am to 5:00pm averaging forty (40) hours per week. Working hours may vary based on business needs.

 

Travel

Travel in and outside of Circuit 13 (Hillsborough County) is required.

 

Training

All employees must complete fifteen (15) hours of on-line or classroom Training on an annual basis.  If the employee is a Certified Child Welfare Professional, Training hours must total twenty (20) annually.

 

Supervisory Responsibilities

This position has no supervisory responsibilities

Qualifications

Education and Experience

• Bachelor’s Degree from an accredited college or university is required.
• Official transcripts are a mandatory requirement
• Strong organizational skills and problem-solving abilities is a must; and
• Ability to establish and maintain positive working relationships is also a must.

 

Skills and Abilities

Must be able to operate standard modern office machinery, including fax, telephone, calculator, computer, scanner, printer, copier, and mail machine.  Minimum typing speed of 45 wpm; excellent word processing skills.  Must be competent with Microsoft Office Suite programs, including Word, Excel, and Outlook.  Must be competent with basic e-mail protocol and procedures including sending, receiving, replying, attachments, and meeting scheduling; effective listening skills; ability to work as a team member, and the ability to work in a multi-cultural environment. Must possess excellent organizational skills and abide by the highest standards of confidentiality.

 

pre-employment requirements

Certificates, License, Registrations, backgrounds, drug screens, Etc.

• Valid driver’s license required, with a clean driver’s license check, and proof of insurance
• Driver’s license check is a requirement
• No special certification or registration is required for this position
• Criminal background screening (fingerprinting) (Local Law Enforcement and FBI/FDLE), and Abuse Registry Check
• Drug Screening is a requirement
• Children’s Network participates in E-Verify

 

Other Requirements

 

Language Skills

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions, common inquiries, or complaints from groups of managers, clients, customers, and the public. Ability to speak effectively before groups of customers or employees.

 

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, percentages, ability to draw and interpret bar graphs.

 

Reasoning Ability

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.  Ability to be proactive, as well as handle problems involving several concrete variables in standardized situations. Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

 

Physical Demands

The physical demands of this position are generally moderate. The role may require extended periods of sitting, standing, and using a computer. Occasional lifting of office supplies, files, or materials up to 25 pounds may be required. Reasonable accommodation can be made to enable individuals with disabilities to perform the essential job functions.

WORK ENVIRONMENT

This is an in-office-based position focused on administrative work, where the noise level may be moderate. This role may involve occasional travel among agency locations, extended periods of computer work, and frequent interactions across multiple departments. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential job functions.

 

ADA:   Children’s Network of Hillsborough County, LLC will make reasonable accommodations in compliance with the Americans with Disabilities Act of 1990.

 

EEO:    Children’s Network of Hillsborough County, LLC does not discriminate based on race, national origin, gender, religion, veteran status, or disability in employment, in provision of services, or in access to programs.

 

Children’s Network of Hillsborough County, LLC is a Drug-Free Workplace.

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