Details for 'Healthcare Resource Advocate '

CONFEDERATED SALISH AND KOOTENAI TRIBES

OF THE FLATHEAD NATION

PO BOX 278

PABLO MT  59855

(406) 675-2700

PERSONNEL OFFICE FAX:  (406) 226-2562

WEBSITE ADDRESS: csktribes.org

E-mail melanie.piedalue@cskt.org

****V A C A N C Y   A N N O U N C E M E N T****

TITLE:                       Healthcare Resource Advocate (1 or more positions)

LOCATION:              Tribal Health Department – St. Ignatius

SALARY:                   $19.89 - $22.87 per hour, plus benefits - May be employed under contract

CLOSING DATE:      Thursday, December 7, 2023 at 5:30 p.m. (MST)

GENERAL DESCRIPTION OF WORK:

Responsible for the efficient and effective outreach and enrollment to the beneficiary population that may be eligible for alternate resources such as Medicaid, Medicare, Veterans Healthcare Benefits, Private Insurance.

Responsibilities include scheduling, pre-registration, registration, authorization, and alternate resource counseling. Monitors and measures division operational standards, including being able to identify upon request the number of new beneficiaries signed up for new alternate resources.  

The employee will also be responsible to optimize customer service to ensure a positive patient experience while processing Medicaid applications or receiving Statement of Fact interviews.

Will work as part of a team dedicated to expanding health care access through the use of alternate payers (other than THPC).

Specific Duties include:

Manages day to day THD referrals for increased health care access using established policies, regulations and standards. The goal is to have increased eligibility for health care through alternate payers such as Medicaid, Medicare, Veterans Healthcare Benefits, private insurance.

Develops a report on “day one” that lists all referrals and outcomes (who became eligible or why not). Can provide accurate information on referrals upon request by Division Managers, Department Head, etc.

Ensures adherence to policy, procedures, regulations and eligibility criteria of the various payers.

Reviews insurance and demographic data with Patient Registration weekly.

May assist with an alternate resources eligibility situation as part of a CHEF case or high cost case.

Develops and provides a weekly productivity and performance report that details referrals in and actions taken to enroll beneficiaries in alternate resources.

Maintains up to date knowledge of computer systems, insurance/government regulations and beneficiary access policies which are used to determine eligibility for alternate resources. 

Coordinates with Data IT division manager to create a beneficiary query and or reporting of beneficiaries that need alternate resource coverage.  Sets up a system to communicate and assist these beneficiaries with information and education.

Can describe, seek, obtain and maintain a data report format that illustrates new alternate resources sign ups by source (Medicaid, VA, PI, and Medicare).  Sets a baseline in February 2016 and maintain consistent reporting thereafter using RPMS data (showing those that obtained alternate resources eligibility). 

Maintains a system to monitor insurance end dates so that beneficiaries may continue their coverage.  Assists beneficiaries with all information necessary to sustain new coverage.

Maintains knowledge of government, private and commercial insurance coverage available to community.

Develops extensive knowledge of government, private and commercial health care and social service resources available to the community.

During alternate resources sign up, encourages THD beneficiaries to use THD clinics for primary medical care.   Develops mechanisms to encourage full utilization of THD clinics. 

MINIMUM QUALIFICATIONS (AS REFLECTED ON THE TRIBAL EMPLOYMENT APPLICATION):

• Bachelors or Associate Degree in Social Work, Medical or Business Administration or minimum of five (5) years increasingly responsible and relevant work experience including 2 years’ experience working with the RPMS data system
• Valid and unrestricted driver’s license.

SUBMIT:

1. Completed Tribal employment application.
2. Copy of academic transcripts, certifications, licensures
3. Copy of valid driver’s license.
4. If claiming Tribal Preference, Proof of enrollment from a federally recognized Tribe if not from CSKT.
5. If claiming veteran’s preference, a copy of the DD214 must be submitted.

SUBMIT ALL OF THE ABOVE TO:   Personnel Office, PO Box 278, Pablo MT 59855, Telephone (406) 675-2700 Ext. 1040, or personnel@cskt.org

FAILURE TO SUBMIT ALL OF THE ABOVE INFORMATION WILL RESULT IN IMMEDIATE DISQUALIFICATION DURING THE SCREENING PROCESS

FOR MORE INFORMATION: Contact Patryce Caye at THD (406) 675-2700 Ext. #7364