Population Health Resource Coordinator

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

General Purpose of Job :

The Pop Health Resource Coordinator will serve as an Advocate / Representative for :

• Members that may qualify for various waivers established by the Texas Department of Aging and Disability (DADS). The incumbent will work with identified members to determine the member's waiver eligibility, submit information to DADS for determining waiver eligibility, and assisting the member's legally authorized representative (LAR) to comply with DADS requirements.
• Members seeking disability services with Social Security Administration (SSA). The incumbent will gather pertinent health history as it relates to member's disability, assist qualifying members determine required documentation, perform telephonic outreach and / or home / site visits to procure medical evidence and complete necessary applications. The Population Health Resource Coordination will maintain ongoing contact with SSA and member to update on case status and will maintain current logs and reports of case outcomes.

The Pop Health Resource Coordinator will also assist in :

Essential Duties and Responsibilities :

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by Health Plan leadership, as required.

Knowledge, Skills and Abilities :

Working knowledge of current Medicare / Medicaid guidelines. Community agencies / resources, financial programs, i.e., AFDC / SSI. Familiar with Health and Human services as it pertains to disability criteria. Experience with largely pediatric populations. Ability to work with multidisciplinary staff. Ability to work with individuals with intellectual and physical disabilities within a therapeutic interdisciplinary environment. Communicate effectively in oral and written communication, trains others, maintain records, and prepares concise reports. Microsoft Office skills preferred. Maintains utmost level of confidentiality at all times. Maintains compliance with regulatory agencies that conduct intermittent reviews and audits to ensure contractual and regulatory compliance with Federal, State entities as well URAC. Implements and adheres to Health System and Health Plan policies and procedures for all members as well as those with special health care needs (STAR Kids, STAR, CHIP, STAR AAPCA) Demonstrates business practices and personal actions that are ethical and adhere to Corporate Compliance and integrity guidelines.

Responsibilities :

Function in an advisory role to the Medical Directors and Medical Management Committee in the following areas :

This position shall be responsible for the following aspects of the program :

Education and / or Experience :

Language Skills :