HOME/COMMUNITY BASED SERVICES REFERRAL COORDINATOR - HEALTH PLAN SERVICES

Cook County Health and Hospitals
$28.494 HOURLY
life insurance, paid holidays, sick time
United States, Illinois, Chicago
1969 Ogden Avenue (Show on map)
Sep 18, 2024
Job Posting : Sep 18, 2024, 3:44:38 PM Closing Date : Oct 3, 2024, 4:59:00 AM Full-time Shift Start Time : 8:00 A.M. Shift End Time : 4:00 P.M. Collective Bargaining Unit : AFSCME 1111 Health and Hospital Systems Posting Salary : $28.494 HOURLY Organization : Health and Hospital Systems LOCATION: John H Stroger Hospital SHIFT: 8:00AM - 4:00PM AFSCME 1111 Job Title Department Home/Community Based Services Referral Coordinator Health Plan Services Job Summary Working with a team of Home/Community Based Services (HCBS) Waiver staff members, the HCBS Referral Coordinator assists with the completion of the administrative tasks to support the requirements of the Department of Rehabilitation Services (DRS) and Department of Aging (DOA). Timely completion of forms, authorizations and data entry supports the provision of care and timeliness of services. The referral coordinator also responds to vendor questions regarding authorizations and service plans in a timely manner. Typical Duties * Completes initial authorizations consistent with service plan details. * Updates authorizations based upon changes in service plan requirements. * Updates file with end date authorizations when the member has switched to another Managed Care Organization, is hospitalized, or is out of the country for a prolonged period or opts out. * Forwards authorization information to providers upon authorization entry. * Answers all inquiries in regards to authorizations from CountyCare, vendors or complaints. * Notifies supervisor of vendor related issues. * Processes waiver transfers, ensure transfer forms are completed in time and loaded into care management system. * Reviews Long Term Services and Support members with personal assistants and monitor service claims. Compare and contrast to authorization and service plan requirements in effect at the time of the claims. * Compiles packets of authorization information * Prints Determination of Need (DON) documents from agency and upload into care management system. * Provides a list of non-contracted agencies to CountyCare provider relations. * Supports completion of Electronic Voice Verification (EVV) forms * Performs other duties as assigned. MINIMUM QUALIFICATIONS: High School Diploma or GED is required. (Must provide official copy of diploma at time of interview) A minimum of two (2) years of experience in claims processing or utilization review is required. A minimum of one (1) year of managed care experience is required. A minimum of one (1) year of experience using electronic systems to retrieve or review data is required. A minimum of one (1) year of experience with a health care organization is required. VETERAN PREFERENCE PLEASE READ When applying for employment with the Cook County Health & Hospitals System, preference is given to honorably discharged Veterans who have served in the Armed Forces of the United States for not less than 6 months of continuous service To take advantage of this preference a Veteran must: * Meet the minimum qualifications for the position. * Identify self as a Veteran on the employment application by answering yes to the question by answering yes to the question, "Are you a Military Veteran?" * Attach a copy of their DD 214, DD 215 or NGB 22 (Notice of Separation at time of application filing. Please note: If you have multiple DD214s, 215s, or NGB 22S, Please submit the one with the latest date. Coast Guard must submit a certified copy of the military separation from either the Department of Transportation (Before 9/11) or the Department of Homeland Security (After 9/11). Discharge papers must list an Honorable Discharge Status. Discharge papers not listing an Honorable Discharge Status are not acceptable OR A copy of a valid State ID Card or Driver's License which identifies the holder of the ID as a Veteran, may also be attached to the application at time of filing. If items are not attached, you will not be eligible for Veteran Preference VETERANS MUST PROVIDE ORIGINAL APPLICABLE DISCHARGE PAPERS OR APPLICABLE STATE ID CARD OR DRIVER'S LICENSE AT TIME OF INTERVIEW. MUST MEET ALL REQUIRED QUALIFICATIONS AT TIME OF APPLICATION FILING. BENEFITS PACKAGE * Medical, Dental, and Vision Coverage * Basic Term Life Insurance * Pension Plan * Deferred Compensation Program * Paid Holidays, Vacation, and Sick Time * You may also qualify for the Public Service Loan Forgiveness Program (PSLF) For further information on our excellent benefits package, please click on the following link: http://www.cookcountyrisk.com/ Degrees awarded outside of the United States with the exception of those awarded in one of the United States' territories and Canada must be credentialed by an approved U.S. credential evaluation service belonging to the National Association of Credential Evaluation Services (NACES) or the Association of International Credential Evaluators (AICE). Original credentialing documents must be presented at time of interview. COOK COUNTY HEALTH AND HOSPITALS SYSTEM IS AN EQUAL OPPORTUNITY EMPLOYER.