Program Assistant

Program Assistant at Partners In Diversity, Inc. Program Assistant at Partners In Diversity, Inc. in Orange, California Posted in 2 days ago.

Type:

full-time

Job Description:

The Program Assistant (Enrollment - Medi-Cal) will provide assistance with specialized services for Medi-Cal eligible members, including data reporting, analysis and reconciliation. The incumbent will be responsible for maintaining eligibility accuracy by monitoring, updating and reviewing the current Medi-Cal program requirements.

Position Information:

Department:

Customer Service Compensation:

$23.92 - $33.48

DOE Work Arrangement:

Full Office Work Schedule:

Monday through Friday; 8:00 a.m. to 5:00 p.m.

Expected Assignment Duration:

up to a maximum of six (6) months or 960 total hours worked from start date.

Duties & Responsibilities:

95% - Program Support Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Coordinates specialized processes, including eligibility analysis, strategic provider assignments, age restriction and complex condition member administration/monitoring and floor audits for the Medi-Cal program. Assists with completing various members requests, such as Change of Health Network Requests, primary care provider (PCP) change requests and data correction forms. Responds to questions and interprets policies and regulations. Prepares materials (e.g., letters/surveys, etc.) and coordinates data files to arrange for mail merge of materials as applicable. Assists with ensuring processes are accurate and compliant with the regulatory requirements by maintaining and documenting process workflows, desktop procedures and policies. Represents the Medi-Cal program on projects or as a liaison within or outside Health. Facilitates communication on specialized topics. Prepares reports and creates reporting tools; performs special reconciliation procedures, including Excel sorts and mergers, filters and compiling reports and Access database procedures. Acts as liaison between the Enrollment department and other Customer Service staff. \ Supports with quality assurance audits to validate the accuracy of Protected Health Information / Appointment of Representative (PHI/AOR) and Acceptance Letter updates processed by other staff members. Conducts outreach to members for various Enrollment department reasons. Conducts outreach to health insurance carriers to verify potential Other Health Coverage (OHC). Assists with processing mailed-in member surveys submitted by manually updating members' profiles with various updates, including demographic changes, other health coverage, and address changes. Responsible for opening, sorting, reviewing, and tracking of returned mail by maintaining an organized and accurate log to ensure timely submission for monthly text campaigns. 5% - Other Completes other projects and duties as assigned.

Minimum Qualifications:

High school diploma or equivalent PLUS 1 year of experience of eligibility and/or reconciliation required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

Preferred Qualifications:

Health insurance experience (Medi-Cal). Prior experience interacting with regulatory agencies, including Department Health Care Services (DHCS) and Department of Managed Health Care (DMHC) and practices related to Medi-Cal. Experience in a Health Maintenance Organization (HMO), managed care or Medi-Cal setting. Customer Service experience. Bilingual in English and in one of Health's defined threshold languages (Arabic, Farsi, Chinese, Korean, Russian, Spanish, Vietnamese).