PACE Intake and Enrollment Specialist at Hudson Headwaters Health Network – Glens Falls, New York

The Program of All-Inclusive Care for the Elderly (PACE) is a community-based program that provides coordinated medical and social services to eligible older adults who want to continue living in their own home despite chronic care needs. The Intake and Enrollment Coordinator will assist with the intake and enrollment process for potential PACE participants. The coordinator will work independently to take and track inquiries and referrals into the program, gather information, provide an explanation of PACE services, and set up appointments for assessments, visits, and tours. The coordinator will interact with family caregivers and potential participants and will provide tours of the PACE Day Center as needed and will gather critical information for the new participant enrollment process.

Essential Duties and Responsibilities:

• Serves as the initial encounter for individuals interested in the PACE program; provides courteous and friendly customer service in person and over the phone demonstrating great commitment to the PACE mission.
• Gathers all necessary information and answers questions while educating individuals about available services.
• Assists in collecting all individual’s demographic information and required paperwork throughout the enrollment process within designated timeframes.
• Conducts eligibility screening, phone intake, education, and enrollment assistance activities to initially determine participant needs and eligibility for enrollment.
• Maintains referrals spreadsheet and communicates back to referring providers on status of referrals made to PACE.
• Develops and maintains relationships with potential PACE participants who call and/or email to inquire about PACE, working to secure a face-to-face meeting with an enrollment specialist.
• Provides individuals with information about Medicaid benefits, eligibility requirements, and other community support services.
• Maintains accurate and up-to-date records of potential participants information.
• Has the ability to interact professionally and respectfully with geriatric individuals including those with cognitive decline and/or physical frailties.
• Analyzes information gathered from potential participants to determine eligibility and ensure appropriate services are accessed.
• Ensures compliance with program rules, regulations, and policies.
• Stays current on changes to Medicaid policies and procedures through ongoing training and development.
• Makes referrals to other agencies or services as needed.
• Identifies and tracks issues, trends, and efficiencies in the PACE enrollment process; presents solutions to barriers for enrollment.
• Responsible for understanding and documenting medical and social indications of potential PACE participants to determine initial need.
• Works as part of a team to educate potential participants and their caregivers on the benefits of the PACE program.
• Conducts tours for potential participants and caregivers at the PACE Day Center and explains the services provided.
• Other projects and duties as assigned.

Qualifications

The requirements listed below are representative of the knowledge, skill, and ability to perform the essential functions:

• Associates Degree in related field preferred or relevant work experience.
• Minimum one year of experience working with a frail or elderly population or must receive appropriate training upon hire.
• Proficient in the use of Microsoft Outlook products such as Word, Excel, and Outlook.
• Experience with data entry and database management using Electronic Medical Record (EMR) systems or equivalent strongly preferred.
• Excellent communication skills, with an ability to adapt communication style to a wide variety of audience and strategies.
• Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and multi-task with high level of quality and productivity and maintain numerous initiatives with time sensitivity.
• Working knowledge of principles and practices of healthcare, healthcare systems, managed care, Medicare, and Medicaid benefits regulations a plus.
• Able to work positively in a diverse and stressful environment.
• Valid Driver’s license.
• Flexibility to travel throughout the PACE service area.
• This is an on-site position and is not eligible for remote work.

Physical Requirements:

While performing the duties of this job, the employee is regularly required to:

• Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards