Description: Job Summary:
Identifies early stages and potential cases for Medicaid/Quest referral. Provides overall management of Medicaid application process. Acts as liaison for Department of Human Services (DHS). Coordinates data gathering efforts of Medicaid/Quest applications. Serves as Regional subject matter expert on community resources. Develops departmental policies and procedures.

Essential Responsibilities:

Develops, coordinates, and facilitates a network of community resources for patients.
Identifies, plans and implements process for timely notification of patients with no insurance and/or patients requiring Medicaid/Quest from Admissions, Business Office, UM Pre-admission Screening, and Support Services.
Acts as liaison for DHS to Social Services department. Establishes rapport with key personnel in DHS offices. Develops more efficient/effective processes of timely approval.
Orients and trains all social services staff on DHS eligibility process and procedures, defines needs, arranges continuing education of assigned staff on new procedures or updates from DHS.
Develops and implements departmental policies and procedures related to Medicaid/Quest process. Monitors changes in regulations. Informs social workers and other staff of changes. Recommends procedure changes.
Reports problems and progress to supervisor. Collaborates with supervisor in resolution.
Coordinates intake of all referrals for Medicaid/Quest applications. Coordinates timely processing of entire Medicaid/Quest application process with members in preparation for alternative levels of care and placement. Makes long-term placement recommendations based on assessment of Medicaid eligibility.
Represents Kaiser Social Services at community meetings with DHS as directed.
Attends community seminars and workshops specific to professional needs. Maintains network of information with peers in community.
Participates formally and informally in approved educational programs.
Ensures success of DHS eligibility and timely discharge of placement patients. Basic Qualifications: Experience

Minimum two (2) years of healthcare or acute care experience dealing with third party liability, Medicare and/or state agencies.
Education
Bachelors degree in social work, public health, or related area, OR four (4) years of experience in a directly related field. License, Certification, Registration N/A Additional Requirements:
Working knowledge of state and federal government health care programs and application processes.Demonstrated ability to produce and present management reports.Demonstrated knowledge of and skill in adaptability, conflict resolution, decision making, diplomacy, customer service, group presentations, influence, interpersonal relations, oral communication, problem solving, project management, quality management, results orientation, teamwork, and written communication. Preferred Qualifications:
DHS application experience.Case management experience.Knowledge of healthcare information systems.Working knowledge of medical terminology.