Quality Coordinator, Health Insurance Programs

The Nassau-Suffolk Hospital Council based in Hauppauge, NY, is seeking a full-time Quality Coordinator, Health Insurance Programs. Reporting Director, Health Insurance Programs, the position holder will be responsible for overseeing the quality of applications and enrollment activity of the Consumer Assistance Program for the Aged, Blind, and Disabled and for the daily activities of the Consumer Health Advocates Program.

This is a grant-funded position, with the possibility of renewal yearly. The hourly rate for this position is between $30.76/hr. and $32.30/hr. Payrate offered will be based on the successful candidate's relevant experience, knowledge, skills, and abilities and in consideration of internal equity.

Key responsibilities include but are not limited to:

• Upon hire attend a mandatory, company-paid 15-hour online training for Certified Application Counselors (CAC) with the NY State of Health (NYSOH); complete course requirements and pass all certification tests to become a registered CAC with the NYSOH online marketplace for the purpose of providing application assistance for the aged, blind, and disabled populations that meet enrollment requirements of the online marketplace.
• Maintain certification as a CAC with the NYSOH by attending all NYS mandatory webinar training sessions during the months of July through October every year; total of approximately 25 hours of company-paid training each year.
• Attend the following company-paid training webinars within 10-days of hire: Applying for Medicare as a Condition of Medicaid Eligibility and Facilitated Enroller Medicare ABD Outreach Program
• Oversee the quality of application packets submitted by the enrollment staff of the Aged, Blind, and Disabled program; review applications to ensure they meet submission requirements to the local DSS office for the following programs: Medicaid, Medicaid Buy-In for Working People with Disabilities, Medicaid spend-down programs, Medicare Savings Programs, and Medicaid for long-term home care and institutionalized care.
• Monitor the work of the Consumer Health Advocates (CHA) program; attend the monthly CHA meetings via zoom to remain current on policies and regulations.
• Coordinate with Support Assistant to ensure all CHA cases and stories are entered into the CHA database. Monitor timeliness of cases submitted and notify the director by mid-month if case submissions are below program deliverables of 55 per month.
• In the absence of the Lead Facilitated Enroller, support the facilitated enrollers by providing technical support on Medicaid, Medicare and CHA cases both in the office and for those at a site in the community, which includes but is not limited to, fielding eligibility questions, helping with complex cases, identifying application errors, provide guidance to correct errors, track all Medicaid applications in the NSHC database, monitoring the any data errors entered by enrollment staff and working with the program director to monitor overall enrollment activity and performance
• Serves as backup to Facilitated Enrollers and Lead Facilitated Enroller by filling in at enrollment sites and handling walk-in cases when enrollers are out sick, vacation, etc.; responsible for completing Medicaid applications in addition to providing quality assurance on all other cases
• Identify error patterns made by enrollment staff either individually or as a group; work with Lead Enroller to review errors to help improve performance; work with Lead Facilitated Enroller and Director to develop group training review sessions to help improve overall performance; assist director to conduct a minimum of one group session quarterly with enrollment staff to provide feedback on overall performance, and conduct case reviews with enrollment staff include a review of common errors made.
• Provide back-up to administrative assistant by mailing application packets and supporting documentation to the local DSS office when assistant in absent or on vacation.
• Assist Director in monitoring cases assigned to enrollment staff by the administrative assistant for clients wanting to complete applications by phone; ensure that staff are making timely follow-up calls; monitor number of calls that result in cases per individual enroller.
• Assist in answering incoming calls to the main line of the Nassau-Suffolk Hospital Council; direct calls to specific employees as needed, answer questions and/or provide site locations to those seeking enrollment assistance as needed.
• Maintain confidentiality of information contained in all applications and case histories of each program; HIPAA and yearly internal security training sessions must be attended, and protocols must be followed as specified by HANYS

Qualifications

• Three years' experience working with public health insurance programs required; bachelor's preferred. An equivalent combination of education and experience sufficient to satisfactorily perform the duties of the job may be substituted.
• Experience providing direction and supervision to a diverse workforce.
• Ability to process and synthesize information and make recommendations, decision-making skills.
• Ability to communicate succinctly through writing and verbal communication; ability to convey technical language as it relates to public health insurance programs and accessing healthcare services.
• Ability to handle adversity productively and be able to tolerate stressful situations.
• Ability to be self-aware to recognize own mistakes and take accountability.
• Role requires travel within Nassau and Suffolk Counties (up to 35% of work time is spent outside of office); reliable transportation is required.
• Ability to maintain a flexible work schedule of 37.5 hours a week with occasional evenings and weekend hours in the event coverage is needed.
• Possess effective time management, organization, and planning skills; be able to meet all deadline requirements.
• Be able to display teamwork, adaptability, reliability, integrity, and initiative.

This position is currently accepting applications.

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