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Entitlement Eligibility Coordinator
 Metropolitan Jewish Health System | |
 United States, New York, New York | |
 July 31, 2023 | |
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The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms. The Entitlement Coordinator maintains up-to-date knowledge of HomeFirst Managed Long Term Care Plan (MLTCP) and the entitlement process. Entitlement Coordinator is responsible for conducting mail and telephonic outreach to verify and assist in the Medicaid enrollment eligibility of a Prospect. This individual coordinates Nursing Home discharges with HRA/LDSS, the Nursing Home, HomeFirst Clinical Enrollment and UM departments, and the prospect/caregiver. Entitlement Coordinator reviews, analyzes, and reconciles all enrollment files from Maximus, including rejections, and compares them to Homefirst Upload files. This individual proactively troubleshoots and coordinates with HRA/LDSS to ensure the accuracy of outgoing and incoming eligibility information and provides solutions to issues as they arise. Entitlement Coordinator has extensive knowledge of HRA/LDSS and NY state systems, such as eMedNY / ePaces and knows how to utilize these systems to confirm enrollment eligibility. This individual is responsible for assisting in the oversight and maintenance of all logs & reports associated with Entitlement, which delineate productivity, timeframes, and quality of HomeFirst Enrollment's Entitlement processes and outcomes. Entitlement Coordinator adheres to all HIPPA standards and confidentiality requirements and is responsible for problem solving as new duties arise and volumes fluctuate.
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