Long Time Services and Supports (LTSS) Coordinator

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

Under the direction of the LTSS manager and Care Manager, the LTSS Coordinator is a member of a team that provides support to our Medicaid members receiving Long Term Services. As an integral team member, the LTSS Coordinator will conduct monthly calls and work in conjunction with the Care Manager to ensure the member receives appropriate and necessary services, ensuring members are connected to care, engage with the member and the member's care team to improve their health and community resources that will support their well-being to ensure quality outcomes (i.e., reduction in emergency room visits and hospital admissions, improved member satisfaction, closing and reducing Gaps in Care) and cost effectiveness. The LTSS Coordinator will also support the Manager with assignments, reports, referrals, and electronic notifications.

• Conducts monthly calls to all members assigned and ensures compliance with HIPAA verification.
• Utilize the LTSS monthly assessment and other SDOH assessments when speaking with the member.
• Employ critical thinking and judgment when dealing with unplanned issues and escalates clinical issues to the members' designated care managers.
• Accurately and timely documents member call interaction in the care management system, Disease Care Management System (DCMS) other applicable software programs are in compliance with professional standards and regulatory guidelines.
• Ensure members have appointments with their providers.
• Fulfills basic care coordination tasks for the member such as appointments, transportation, medication issues such as needing prescription or refill, DME, etc.
• Conducts other supportive activities as assigned.
• Problem-solve members' issues in an independent, resourceful manner.
• Perform non-clinical activities for members of varying age, clinical scenario, culture, financial means, social support, and motivation.
• Engage members/caregivers in a collaborative relationship, empowering them to manage their physical, psychosocial, and environmental health to improve and maintain lifelong well being.
• Promote communication, both internally and externally to enhance effectiveness of clinical and non-clinical services and overall case management services.
• Maintain accurate and complete documentation of required information in compliance with risk management, regulatory and accreditation requirements.
• Protect the confidentiality of member information and adheres to all company policies regarding confidentiality.
• Collect and prepare data, statistics, proposals and reports relevant to responsibilities as a LTSS Coordinator.
• Provides care coordination that reduces avoidable utilization, increases member satisfaction and retention, and reduces gaps in care.
• Assists all MetroPlusHealth departments with resolution of related member retention, utilization management, quality management, customer service, and provider relations concerns.
• Performs other appropriate duties and participates in other special projects as assigned, including, but not limited to, audit review and preparation, quality improvement, community health education, facility/provider relations and marketing activities.
• Comply with all orientation requirements, annual and other mandatory trainings, organizational and departmental policies and procedures, and actively participate in evaluation process.
• Ensures compliance with Federal, State, and City regulations, and is consistent with the Mission, Vision, and Values of the organization.

• Associate's degree required. Bachelor's degree preferred from an accredited college or university in a healthcare related field.
• A minimum of 4 years of experience in a healthcare-related field is required. Managed Care, care management/coordination, health education, health home or community-based experience is preferred.
• Proficiency with computers navigating in multiple systems and web-based applications including Excel.

Professional Competencies

• Integrity and Trust
• Customer Focus
• Functional/Technical Skills
• Written/Oral Communication
• Strong customer service skills to coordinate service delivery including attention to members/caregivers, sensitivity to concerns, proactive identification and rapid resolution of issues to promote positive outcomes for members.
• Demonstrated ability to communicate effectively, problem solve and work effectively with people.
• Excellent time management and organizational skills.
• Ability to prioritize and manage changing priorities under pressure.

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