Community Health Choices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid.
The CHC Assistant Service Coordinator assists in providing service coordination services across the continuum of care through a community-based approach to improve health outcomes of the Participant served. This role contributes to the LTSS care coordination process by providing telephonic support to Participants and Service Coordinators through a collaborative process to promote quality, cost-effective outcomes. This role helps assess, plan, implement, coordinate, monitor and evaluate options and services to meet an individual's health needs to include identifying physical health, behavioral health, social services and long-term services and supports.
This is a full time position working Monday through Friday daylight hours and will be a remote position. Experience working in a nursing facility will be highly considered for this position.
Responsibilities:
- Establish and build strong relationships with both internal team Participant s and partner provider foster a collaborative environment.
- Assist Enrollee in navigating and accessing LTSS services or programs and/or eliminating duplication of services.
- Share with parties who need the Care Plan in connection with their supports of the Participant, including Participant s of the Participant 's care team and other providers who serve the Participant (i.e. state agency or service coordinator assigned to case
- Collect program data to track participant progress on a monthly basis to ensure to OPS reporting completed per regulatory deadline and that compliance requirements
- Responsible for performing profession-level administrative duties involving research, analysis and reporting.
- Prepare reports regarding service provision and update service plan in accordance with governing bodies.
- Assist with Service Coordinators and Service Coordinator Associates with escalation issues.
- Conduct monthly and other calls to participants
- Research and assist in resolving authorization issues, including securing providers and assisting in obtaining authorizations.
- Assist Participant s in obtaining HCBS services that will support independent living
- Identify, coordinate and assist Participant s in gaining access to needed LTSS and Medical Assistance services, as well as non-Medicaid funded medical, social, housing, educational, and other services and supports.
- Providing information to Participant s and facilitating access, coordinating and monitoring LTSS needs for Participant s.
- Informing Participant s about available LTSS, required assessments, the Person -centered service planning process, service alternatives, service delivery options including opportunities for Self -direction, roles, rights including DHS Fair Hearing rights, risks and responsibilities, and to assist with fair hearing requests when needed and requested, and to protect a Participant s health, welfare and quality on on-going basis
- Collect s additional necessary information, including, at a minimum: Participant preferences, strengths and goals to inform the development of the PCSP Conducts reevaluation of level of care annually or more frequently as needed.
- Assist the Participant and his or her PCPT in identifying and choosing willing and qualified Providers.
- Works with the Participant to complete activities necessary to maintain LTSS eligibility.
- Explores coverage of services to address Participant identified needs through other sources, including services provided under Medical Assistance,
- Medicare or private insurance and other community resources.
- Actively coordinates with other individuals and entities essential in the physical and behavioral care delivery for the Participant to provide for seamless coordination between physical, behavioral and support services.
- Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.
Maintain confidentiality and adhere to HIPAA requirements.
*Performs in accordance with system-wide competencies/behaviors.
*Performs other duties as assigned.
%3Cul style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:12px 0px;orphans:2;padding:0px 0px 0px 20px;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3EHigh School Diploma required.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3E2 years of data entry or customer service experience required.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3EPreferred experience working with people with disabilities or seniors in need of LTSS; and knowledge of the home and community-based service system and how to access and arrange for services.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3EProficiently and effectively read, write and communicate in English.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3EAdditional language capability is preferred.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3ECommunicate in a manner appropriate and respectful to the comprehension level of the consumer and/or family.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3ECultural competency and the ability to be sensitive to diverse backgrounds and set aside personal opinions and implicit biases.%26nbsp;%3C/li%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3E%3Cp style=%22margin:0px 0px 12px;%22%3EThis includes their basic principles, values, ethics, ways of thinking, customs, practices, and their impact on human culture.%26nbsp;%3C/p%3E%3Cp style=%22margin:0px 0px 12px;%22%3E%26nbsp;%3C/p%3E%3Cp style=%22margin:0px 0px 12px;%22%3E%26nbsp;%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp style=%22margin:0px 0px 12px;%22%3E%3Cstrong%3EHighly Preferred%3C/strong%3E%3C/p%3E%3Cul style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:12px 0px;orphans:2;padding:0px 0px 0px 20px;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cli style=%22font-family:Arial;line-height:1.25;%22%3E%3Cp style=%22margin:0px 0px 12px;%22%3E%3Cspan style=%22font-family:%26quot;Aptos%26quot;,sans-serif;font-size:12.0pt;%22%3E%3Cspan style=%22line-height:115%;mso-ansi-language:EN-US;mso-ascii-theme-font:minor-latin;mso-bidi-font-family:%26quot;Times New Roman%26quot;;mso-bidi-language:AR-SA;mso-bidi-theme-font:minor-bidi;mso-fareast-font-family:Aptos;mso-fareast-language:EN-US;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;%22%3ENursing Facility experience%26nbsp;%3C/span%3E%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3EAdditional language capability is preferred.%26nbsp;%3C/p%3E%3Cul style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:12px 0px;orphans:2;padding:0px 0px 0px 20px;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3E%3Cli style=%22line-height:1.25;%22%3EProficiently and effectively read, write and communicate in English.%26nbsp;%3C/li%3E%3Cli style=%22line-height:1.25;%22%3EAdditional language capability is preferred.%26nbsp;%3C/li%3E%3Cli style=%22line-height:1.25;%22%3ECommunicate in a manner appropriate and respectful to the comprehension level of the consumer and/or family.%26nbsp;%3C/li%3E%3C/ul%3E%3Cp style=%22-webkit-text-stroke-width:0px;background-color:rgb(255, 255, 255);color:rgb(0, 0, 0);font-family:%26quot;Open Sans%26quot;, %26quot;Segoe UI%26quot;, Frutiger, %26quot;Frutiger Linotype%26quot;, %26quot;Dejavu Sans%26quot;, %26quot;Helvetica Neue%26quot;, Arial, sans-serif;font-size:13.02px;font-style:normal;font-variant-caps:normal;font-variant-ligatures:normal;font-weight:400;letter-spacing:normal;margin:0px 0px 12px;orphans:2;text-align:start;text-decoration-color:initial;text-decoration-style:initial;text-decoration-thickness:initial;text-indent:0px;text-transform:none;white-space:normal;widows:2;word-spacing:0px;%22%3EPreferred: Minimum of year of LTSS, Service Coordination or Case Management experience. Environmental Conditions: Ability to work independently in virtual setting and make outbound calls. 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