Follows up on referrals for participant-directed services
Supports the individual/employer and their provider(s) in completing all necessary documentation required for enrollment
Performs all functions necessary to support the enrollment of the individual/employer/authorized representative and provider(s) including processing enrollment documentation, obtaining employer identification numbers, completing criminal background checks, and other enrollment related requirements
Communicates referral corrections, as needed, to entities providing case management or service/support coordination entities services to the individual
Updates enrollment status of individual participants and providers through portal and records in systems. In collaboration with the enrollment supervisor, supports workforce management delegation to ensure service levels are met
Participant Education and Support
Educates the individual/employer on interacting with Public Partnerships as their fiscal intermediary, with emphasis on their authorized services, timesheet completion, enrolling subsequent providers and keys to successful self-direction
Provides person-centered, need-based program education and guidance to Participants and authorized representatives specific to individual choices, goals and desired outcomes
Explains and educates on Participant/authorized representative and provider roles and responsibilities for participation in self-directed services, including processing payroll, vendor payments, tax withholding and reporting
Provides direct, including train-the-trainer, instruction on how to navigate program rules, expectations and Financial Management Systems, including online enrollment, service time capture, portal and emerging technologies
Provides train-the-trainer instruction on identification and reporting of suspected fraud, abuse, neglect and exploitation
Problem-Solving and Barrier Resolution
Identifies potential barriers and bottlenecks to timely enrollment and takes necessary steps to triage and resolve
Engages the entity providing case management or service/support coordination services to the individual to ensure timely coordination of service approval and authorization
Collaborates with internal and external stakeholders as necessary to ensure enrollment cycle times are minimized and the first payment to the provider(s) is received on time and in full
Compliance and Risk Management
Identifies, reports and appropriately follows up on allegations or reports of suspected fraud
Assesses for participant abuse, neglect, and exploitation, following the appropriate reporting protocol where necessary
Maintains documentation of services provided and time committed in accordance with applicable policies and procedures
Documents and reports evidence of individual's inability to self-direct appropriately
Participant Assessment
Assesses Participant's and/or authorized representative's ability to communicate, acquire new information, act as an employer and otherwise successfully participate in a self-directed employer and/or budget authority service model
Communicates with Participant or authorized representative about additional supports or accommodations necessary for successful program participation
Performs in-home visits of Individuals as applicable by program
Required Skills :
Strong customer service and support experience
Proficient in Microsoft Office
Benefits
Health insurance
Additional Information
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
Job Description
Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and "self" direct their own long-term home care. Our role as the nation's largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services.
Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve. (learn more at www.pplfirst.com ).
Job Summary
The Enrollment Specialist guides individuals through the participant-directed services enrollment process, ensuring timely documentation, coordination, and education. This role provides person-centered support, resolves barriers, and trains participants on program requirements, financial management systems, and fraud prevention to promote successful self-direction.
Publicpartnerships · VA