Responsibilities
The Clinical Assessment Outreach Manager
- Meet referral and enrollment goals set forth by management by building relationships with referral partners to create engagement opportunities with prospective enrollees and their caregivers
- Ensure high performance and productivity of pre-enrollment verifications of Medicare, Medicaid, and PACE eligibility
- Educate referral sources, prospective participants / caregivers, and other audiences on relevant program benefits as well as initiatives and projects
- Provide program education through lectures, presentations, events, meetings or other necessary communications with community and business stakeholders to facilitate PACE referral generation
- Maintain knowledge of all applicable CMS, DOH and PACE-specific guidelines, including organizational and departmental policies and procedures
- Ensure familiarity with & compliance, amongst staff, with state & federal laws regarding Medicaid and Medicare Eligibility and Enrollment regulations
- Directly assist intake activities as necessary, including general qualification screening, documentation collection, benefit education / applications, site tours, home visits, and other follow-up to aid in the enrollment or education of a prospect
- Work closely with the Intake Navigators and Account Managers to schedule in-home or virtual pre-enrollment assessment appointments with prospective participants
- Document all interactions and outcomes in the designated clinical management / electronic record system
- Perform other duties, as needed
Qualifications :
- 1+ year of experience working with a Frail and / or Elderly population
- Bachelor's Degree in Nursing
- NYS Registered Nurse (RN) license
Desired Skills :
- 3+ years of experience in Geriatrics, Home Care, MLTC (Managed Long-Term Care), MAP (Medicare Advantage Plan), D-SNP (Dual Special Needs Plan), and / or PACE (Program of All-Inclusive Care for the Elderly) Long-Term Care products
- Familiarity with Community-based Long-Term Care services for dual-eligible and frail adult populations
- Knowledge of the Uniform Assessment System of New York (UAS-NY)
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