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Job Postings

Medicaid Managed Care Services:
Specialist, Beneficiary Relations (Little Rock, AR) (Ref: 14-0008 Specialist, Beneficiary Relations)

JOB TITLE: Specialist, Beneficiary Relations

LOCATION: Little Rock, AR

FLSA STATUS: Exempt

GRADE: 23



SCOPE OF POSITION:

Responsible for the development, implementation, and monitoring of a Medicaid Managed Care Services (MMCS) specialty areas related to AFMC’s contractually driven projects. Serve as a subject matter expert on assigned project/contract. Provide communication, education and promotion of program services. Collaborate with medical and other professional staff to meet contract deliverables within designated timeframes. Communicate with MMCS staff and beneficiaries ensuring timely provision of services and appropriate follow up. Document services rendered and provider reporting as required.

 

 

ESSENTIAL JOB FUNCTIONS:

1. Manage the overall planning, development, implementation, and evaluation of specialty area as necessary to fulfill contractual obligations.

2. Maintain comprehensive knowledge of specialty area, pertinent organizations, and health care environment. Knowledge should include information regarding: contract, contract deliverables, policies and procedures, resources available, current research and reports, trends, etc.  

3. Responsible for the resolution of customer/client requests including research, referral, policy review, revision and development, documentation and follow up in accordance with established policy/procedures.

4. Communicate effectively with customers and/or recipients. Develop and maintain working relationships as necessary to meet contract deliverables of specialty area project.

5. Act as a resource to internal and external customers for information pertaining to specialty area focus. Serve as AFMC representative at various external functions, as directed.

6. Understand and utilize project-tracking database to document and monitor services/activities provided and to compile a comprehensive database of activity.  Maintain accurate statistical data to meet contractual and other reporting requirements.

7. Coordinate the timely collection and data entry of all required documentation.

8. Assist in the creation and maintenance of necessary forms, publications, reports, and additional documents to track and report project information. Prepare monthly reports and/or statistics as directed.

9. Monitor specific items within the area of focus, provide recommendations/ feedback to external customers for quality improvement and follow through for compliance of recommendations for improvement.

10. Identify, present, and discuss progress and issues relating to specialty area and implement solutions to assist in program development. Ensure all activities address designated performance goals, the appropriate target audience, and are performed within designated time frame. 

11. Training and knowledge in all other areas of Beneficiary Relations to assist as needed with the overall operation of the Beneficiary Relations department.

12. Assist in the development, production, maintenance and delivery of educational materials/activities.

13. Adhere to format, content and style guidelines, giving consideration to usability and ensuring accuracy, consistency, and quality.

14. Communicate needs and requests to other team members as appropriate.

15. Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance.

16. Additional duties as assigned.

 

Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):

Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed.  Must be able to lift and transport 25 pounds. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.

 

 

EDUCATION:

Required: Bachelor’s degree in health sciences field, business or related field. May require a specific license in one or more of the following areas, dependent upon position:  EMT, Paramedic or Certification for inspection of vehicles, etc  1

     

EXPERIENCE:

Required: Three (3) years in the focus area of the position which includes, ambulatory care, emergency transportation, case management, customer relations, vehicle maintenance, etc.

Desirable: Experience within the healthcare arena, knowledge of the government procurement cycle and understanding of the Medicaid Guidelines and/or QIO experience

 

 

KNOWLEDGE, SKILLS AND ABILITIES:

Must possess intermediate level computer skills (Excel, Word, Power Point and Outlook)

Type 50 wpm

Exceptional skills in business English and spelling

Ability to maintain confidentiality

Strong oral and written communication skills

Creativity

Customer service

Ability to meet deadlines

Attention to detail

Flexibility

Knowledge of ICD 9 Coding

Knowledge of HIT/EHR

Medical terminology

Ability to work collaboratively and independently to achieve stated goals

Initiative

Ability to relate professionally and positively with staff, business partners, customers, constituents, beneficiaries and the public

Ability to multitask

Ability to prioritize

Strong organizational skills

Problem solving skills

Professionalism

Project management skills

Ability to read, interpret and apply laws, rules and regulations

Knowledge of quality improvement processes and techniques

Valid driver’s license

Ability to travel including overnight travel

Time management skills


1 Five (5) years work experience in related field may be substituted for the Bachelor’s degree.  If work experience is substituted it is in addition to stated work experience requirements.

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How to Apply with AFMC

To be considered an applicant for a position, complete the apply online form, which is linked under each job description. AFMC conducts drug and nicotine screens, and background checks post-offer.  Upon receipt of your application, AFMC may send you additional documentation to complete. If your qualifications and experience fit with those required for the position, you may be contacted to arrange an interview. The number of interviews can vary. Also, the position may be filled fairly quickly, or possibly remain open for a few weeks. After a decision has been made, the selected candidate will be called with an offer of employment.

The Fair Credit Reporting Act (FCRA) requires that we obtain a separate written consent from the employee before the report is ordered, and we must give written notice to the employee of his or her right under FCRA. If adverse action is taken based on the report, we must give notice to the employee and allow him or her to obtain a free copy of the report. The employee may then dispute and defend its accuracy. Any substance that contains nicotine will produce a positive result on nicotine tests. In addition to cigarettes, this will include chewing tobacco, snuff, nicotine patch, nicotine gum, cigars, etc. All positive results will render applicant ineligibile for employment at AFMC. Those who are denied employment due to a positive nicotine test may reapply to open positions after a period of six months.


EOE/M/F/V/D

Arkansas Foundation for Medical Care is an equal opportunity/affirmative action employer. It is the policy of AFMC to provide equal opportunity for all qualified persons and to not discriminate against any person/applicant for employment because of race, color, religion, national origin, sex, age, disability, veteran status and/or any other status protected by federal, state and/or local law.

***Special Accommodations: If you have a disability and require a reasonable accommodation in the application and/or testing process, you must notify the AFMC Human Resources Department. Requests may be made in person or by telephone (501) 212-8798, by fax (501) 212-8797, by e-mail mdumas@afmc.org or by U.S. mail Attn: Michael Dumas, 1020 West 4th Street, Suite 300, Little Rock, AR 72201.