Managed Long Term Services and Supports Coordinator II

Job Summary

The Managed Long Term Services and Supports Coordinator II is responsible for MLTSS Outreach to members accessing for unmet needs and barriers in care. The position handles question(s) and resolves issues. This position provides members and others with basic information about MLTSS services and commonly requested information, resolves basic issues as possible. This position collaborates with other L.A. Care departments and CBOs as a subject matter expert when implementing new initiatives and educational materials related to MLTSS. The position is also responsible for Long Term Care Institutional Preferred Provider Group reassignment and Long term Care discharge summaries. The position assists the MLTSS department and L.A. Care's contracted Provider Network in understanding MLTSS programs so that we can ensure members, families, and caregivers, have easy access to a service delivery system that improves the well-being of our members while giving them an opportunity to remain living safely in their homes. MLTSS consists of: In-Home Supportive Services (IHSS), Multipurpose Senior Services Program (MSSP), Care Plan Options (CPO), Long Term Care (LTC), Community Based Adult Services (CBAS) and services provided by Community Based Services (CBO).

Duties

Outreaches to member(s) based on HRA data received in MLTSS Queue assessing for unmet needs or barriers in care. Provides general information about MLTSS benefits available and coordinating care by making appropriate referrals to MLTSS programs, community resources and coordinating care with member Preferred Provider Group/PCP when services are put in place. (30%)

Implements and conducts new hire orientation for MLTSS, Customer Solution Center, Social Services, Behavioral Health, Disease Management, Case Management and Utilization Management as needed. (10%)

Responsible for Long Term Care Institutional Member reassignment for member residing in LTC and for members who transition to the community, including processing of LTC discharge summaries assigning member back to a regular PPG. Troubleshoots iPPG reassignment issues such as the direct (25%)

SME in newly implemented Model of Care supporting LTC and CBAS Team, with difficult placement, member transitioning to the community, medical records request, maligns, decertification's and other duties. (25%)

Performs other duties as assigned. (10%)

Duties Continued

Education Required

Education Preferred

Experience

Required:

At least 1 year of related experience, preferably in managed care, Medi-Cal, Managed Long Term Services & Supports, and/or as Medical Assistant.

Skills

Required:

Strong verbal & written communication skills.

Proficiency with Microsoft Word & Excel.

Strong organizational, prioritizing, time management and interpersonal skills, along with sound judgment.

Knowledge of medical terminology.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information