ElderSource, the Northeast Florida Area Agency on Aging in Jacksonville Florida as part of the Aging and Disability Resource Center.
This position is responsible for assisting clients through the Statewide Medicaid Managed Care Long Term Care Program (SMMC LTC) eligibility process.
This professional staff is 100% Medicaid related and shall perform some or all of the following ADRC intake, screening and triage activities that inform eligible or potentially eligible individuals, their families, and/or the community about Medicaid covered services and how to obtain them.
Essential duties and responsibilities
A. Accept referrals from the Elder ADRC Helpline as well as other resources for intake and screening utilizing a standardized screening instrument. B. Determine the individual’s needs and screen for potential eligibility for Medicaid-related services in an efficient, timely and consumer friendly manner. C. Provide efficient, timely and consumer friendly services to facilitate the eligibility application and review process. D. Verify an individual’s current Medicaid eligibility status for purposes of the Medicaid eligibility process. E. Explain Medicaid eligibility rules and the Medicaid eligibility process to prospective applicants. F. Conduct comprehensive screening on Medicaid probable individuals on the Assess Priority Consumer List (APCL) who are not active in a case managed program. G. Input client assessments into CIRTS (Client Information and Registration Tracking System). H. Post information in the enrollment and termination screens of CIRTS to update the APCL as needed. I. Provide necessary forms and package all forms in preparation for Medicaid eligibility determination. J. Assist individuals with acquiring forms and compiling required documentation, provide technical assistance, coordinate with eligibility determination professionals, and perform all other duties related to completing and submitting a formal Medicaid application. K. Gather information related to the application and eligibility determination for an individual, including resource information and third party liability information, as a prelude to submitting a formal Medicaid application. L. Refer the individual to the local (or ADRC collocated) Department of Children and Families/Automated Community Connection to Economic Self-Sufficiency (DCF/ACCESS) staff to make application for Medicaid benefits. Coordinate with these staff regarding eligibility matters for Medicaid eligible or potentially eligible individuals. M. Assist in obtaining the Physician Referral Form (3008) for Medicaid Waiver probable individuals and coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of functional eligibility. N. Package all forms in preparation for Medicaid eligibility determination. O. Collect, review and maintain accurate data on individuals who are going through the Medicaid eligibility process to ensure completeness, accuracy and timeliness. P. Track Medicaid applications through the eligibility process. Q. Assist Statewide Medicaid Managed Care Long-Term Care enrollees with grievances and complaints they may have with their managed care plan, their services, their providers, or the program in general. R. Contact individuals on the Assessed Priority Consumer List (APCL) as required to update information and screen for Medicaid eligibility. S. Participate in meetings with DCF, CARES and other entities as appropriate to facilitate and enhance the Medicaid eligibility determination process. T. Act as a consumer advocate by coordinating with CARES and DCF/ACCESS staff to resolve in a timely manner any eligibility issues that arise during the Medicaid eligibility determination process. U. Standardize and make consistent outreach efforts to ensure public awareness of Medicaid programs and services and how to access them. V. Develop, compile and distribute materials to inform individuals about the Medicaid programs as well as how and where to obtain those benefits. Note: This activity does not include compiling information already available through the Medicaid agency or Department of Elder Affairs. W. Build relationships with and educate providers, professionals and professional entities and other professionals, such as hospital discharge planners and nursing home social workers, to facilitate referrals and increase awareness of Medicaid resources which serve target populations. X. Regularly meet with and train ADRC access points to increase awareness of Medicaid resources to individuals and target populations. Y. Perform other Medicaid-related duties as assigned, which may include counseling disaster victims about Medicaid programs, options and the eligibility process. This job description reflects management's assignment of essential functions; it does not prescribe or restrict the tasks that may be assigned. II. Supervisory Responsibilities This job has no supervisory responsibilities. III. Competency A. To perform the job successfully, this position should demonstrate the following competencies: B. Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs work flows and procedures. C. Oral Communication - Speaks clearly and persuasively in positive or negative situations; listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings. D. Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. E. Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives; Organizes or schedules other people and their tasks; Develops realistic action plans.
To perform this job successfully, this position must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Medicaid staff must have the following knowledge and skill set in order to perform Medicaid functions: 1. Knowledge of computer applications to perform the functions of the position, including word processing, database, and spreadsheet applications; 2. The ability to work independently and with minimal supervision; 3. Knowledge of available ADRC administered programs and available Medicaid programs; 4. The ability to work with disabled adults, elders, caregivers, stakeholders, and community partners in a knowledgeable, engaged, and compassionate manner; and 5. The ability to set and track personal performance goals to efficiently manage workload. 6. Language Skills A. Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. B. Ability to write reports, business correspondence, and procedure manuals. C. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. 7. Mathematical Skills A. Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume. B. Ability to apply concepts of basic algebra and geometry. 8. Reasoning Ability A. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. B. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. 9. Computer Skills To perform this job successfully, an individual should have knowledge of Internet software; Spreadsheet software and Word Processing software. Must have the ability to utilize the computer for database system. 10. Physical Demands The physical demands described here are representative of those that must be met by this position to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, this position is occasionally required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms; climb or balance and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds. 11. Work Environment The work environment characteristics described here are representative of those this position encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, this position is occasionally exposed to outside weather conditions. The noise level in the work environment is usually moderate.
Education and Experience
1. Have a Bachelor’s Degree from an accredited college or university; or 2. Have an Associate Degree from an accredited college or university and a minimum of one (1) year of experience as a caseworker, case manager, intake specialist, or experience in performing human services related work; or Have a high school diploma or GED and two (2) years of experience as a caseworker, case manager, intake specialist, or experience in performing human services related work. Certificates, Licenses, Registrations 1. Must be certified by completing the Aging and Disability Resource Centers Long-Term Care Program Education Certification Survey. 2. Must be certified by the Department as documented by the completion of the Department approved DOEA forms 701S and 701B training modules. 3. Signed acknowledgement that the employee has received, read, and understands the “Prohibited Activities”.
$14.55 per hour