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Prescreen Specialist

Full Time
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Job Description

Under the general supervision of the Coordinator, works with individuals inquiring about the MI Choice Medicaid Waiver program. Provides a general overview of medical and financial eligibility, eligibility guidelines, required documentation and completes prescreen process to determine preliminary eligibility for individuals on the MI Choice Medicaid Waiver waitlist. Conducts both telephone and face-to-face prescreens with individuals. Assists applicants with collecting and submitting required documentation. Schedules assessment appointments for Supports Coordinators. Responsible for tracking and reporting waitlist and prescreen statuses. Identifies barriers to meeting enrollment goals, and assists with developing and implementing strategies to overcome barriers. Assists with outreach in order to increase MI Choice Medicaid Waiver enrollments.

Job Responsibilities

  • Coordinate MI Choice Medicaid Waiver wait list to process individuals in date order in which they were added.
  • Conduct telephone prescreen interviews with individuals on the MI Choice Waiver Wait List to determine interest and potential eligibility for the program.
  • Provide list of necessary paperwork/documents to be collected prior to prescreen and discuss methods to obtain them.
  • Maintain regular communication with individuals/caregivers for the documentation status. Assist individuals with obtaining required documentation and notify individuals of the time frame required to receive the documentation.
  • After required documentation is collected, schedule face to face or telephone pre-screen with individual and other family members, as requested by individual, and prepare necessary documentation.
  • Conduct face to face or telephone interview, collect and scan paperwork, discuss Nursing Facility Level of Care (NF-LOC) criteria, complete person center planning form, discuss self- determination and agency options.
  • Collect individual’s signature on required documents.
  • Schedule initial assessment with individuals who meet preliminary eligibility requirements.
  • Provide hearing notice and adequate action notice for individuals who appear ineligible.
  • Complete all required documentation on paper forms and electronic databases.
  • Assists Eligibility Specialist to review financial eligibility.
  • Identifies and communicates barriers to meeting enrollment goals. Assists with developing and implementing strategies to overcome enrollment barriers.
  • Assists with outreach to increase Waiver enrollments.
  • Collaborate with other programs to provide additional resources to participants, as needed.
  • Complete other duties as assigned.

Required Knowledge & Skills

Knowledge of:

  • Knowledge of health and human services delivery and terminology.
  • Proficient in Microsoft Office products specifically Outlook, Excel, Word and PowerPoint.
  • Ability to learn new software; COMPASS, CHAMPS, MI Health Plan Benefits is required.
  • Working knowledge of current HIPAA requirements as they relate to participant and program confidentiality.
  • Working knowledge of Medicaid Eligibility and Application process.

 

Skills and Ability to:

  • Display excellent oral and written communication skills.
  • Display strong organizational skills and attention to detail.
  • Display sound judgement and decision making skills.
  • Display strong critical thinking and analytical skills.
  • Ability to successfully manage several projects simultaneously.
  • Ability to work independently and in a team environment.
  • Ability to work in a team with the Care Management Department and Community Resources Department management and staff to identify and remediate issues related to Medicaid eligibility.
  • Display professional behavior and maintain appropriate boundaries.
  • Must have reliable transportation.
  • Must possess and maintain valid Michigan Driver’s License and vehicle insurance.

Education & Experience

Education:

  • High School diploma, GED required.
  •  Associates degree in Human Service field preferred.

 

Experience:

  • Two years’ experience or equivalent working in the Human Service or Health Care field.

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