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MetroPlusHealth Summer Internship: Children's Special Services

MetroPlus Health Plan
United States, New York, New York
160 Water Street (Show on map)
April 10, 2024
MetroPlusHealth Summer Internship: Children's Special Services

Job Ref: 103124

Category: Utilization Review and Case Management

Department: MHP CHILDRENS PROGRAM

Location: 50 Water Street, 7th Floor,
New York,
NY 10004

Job Type: Regular

Employment Type: Full-Time

Salary Range: $22.00 - $22.00

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

Join us this summer (June - August) for a highly interactive and engaging internship experience where you get to work alongside various departments to develop your skills and learn more about the health insurance and healthcare industry.

Department Requesting: Graduate Student

Interns will also participate in workshops, activities and other events organized by MetroPlusHealth

*Note: This is a paid internship program. Prospective interns must be current students attending an accredited College or University and must be 18 years or older to be considered.

Job Description

Medical/BH Care Management

  • Notification of care manager of any ED visit or admission. Collecting information available from all sources in DCMS
  • Health Home communication to identify current case manager and assist in identifying HCBS providers.
  • Updating DCMS with the current care management team contact information and ending prior team members information (CMA team members)
  • Assist case management searches for additional contact numbers when families are not reachable (outreaching pharmacies, reviewing attachments, communicating with agencies)
  • Identifying specialist in Metroplus directories who perform specific surgeries and tests
  • Identifying DME providers for unique member needs (custom items and safety equipment)
  • Outreaching community organizations to verify programs and services currently available (NOWPOW, Cribs, Food, pantry, clothes)
  • HEDIS GAPS in Care Claim review to verify dates when parent/care manager reports gaps have been closed- Pharmacy, EPIC, LABS
  • Appointment scheduling assistance to assist families in closing gaps in care.
  • Calls to MAS to schedule transportation for members

Foster Care

  • Updating agencies on members ED visits and Hospitalizations from Daily census under direction of FCL

Administrative Assistance

  • Attaching clinical into CSS folders
  • Attaching and updating POCs in DCMS
  • Monitoring incoming Faxes and faxing externally
  • Complete audits of DCMS cases to ensure relevant fields are populated for accurate reporting (Discharge tabs with appointment info)
  • Meeting Notes for Rounds and scheduled team meetings
  • Reviewing/Audit Waiver members documentation to ensure all cases are compliant with required documentation and reporting findings to management for update
Minimum Qualifications
  • Pursuing a graduate degree in behavioral or physical health care administration/policy
  • Strong Interpersonal Skills.
  • Experience with Microsoft Office (Excel, Word, Visio, etc.)

Professional Competencies

  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Written/Oral Communication

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