Enrollment Specialist

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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.

Duties & Responsibilities

Enrollment Coordination

• 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

Required Skills:

• Strong customer service and support experience
• Proficient in Microsoft Office Suite, CRM, Five 9, My Account platforms and web-based applications
• High aptitude for process assessment, improvement, and recommendations
• Exceptional verbal and written communication skills
• Ability to develop strong working relationships with external and internal stakeholders

Qualifications:

• Education: Education: Related Bachelor’s Degree Preferred; substantial professional experience in a related field may be considered in lieu of formal degree. Additional education and experience requirements as indicated by state contract requirements

• Experience: Minimum of one (1) year of experience serving individuals with disabilities and/ or aging adults preferred.
  

Other Requirements:

• Availability between (8 AM - 7 PM PST)

Compensation & Benefits:

• 401k Retirement Plan
• Medical, Dental and Vision insurance on first day of employment
• Generous Paid Time Off
• Continuing Education Assistance Program
• Employee Assistance Program

Compensation Range:$23.00 - $26.00 per hour

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified

Originally posted on Himalayas