Medicaid Managed Care Liaison

Job Description

Job Description

Job Title : Medicaid Managed Care Liaison Job Description

Reports to : Administrative Director of Nursing- Health Services

Locations : Marian Hall, Brooklyn, EFFC Burnside (Bronx) (Various Locations

Hours : 35 Hours, Non- Exempt (Position requires to staff to be onsite. Hybrid schedules are at discretion of Program Leadership following probationary period)

Job Summary :

Medicaid Managed Care Liaison (MMCPs) are responsible for ensuring there is a highly coordinated approach between Good Shepherd Health Services and the Medicaid Managed Care Plans (MMCPs). All 29-I VFCA Health Facilities are required to have a VFCA Medicaid Managed Care Liaison who will coordinate with the MMCPs. All MMCPs must have a Foster Care Liaison (FCL) who shall be the direct MMCP contact with 29-I VFCA Health Facilities, and work in collaboration with the MMCLs will for monitoring access to health care for children in foster care.

Responsibilities :

The VFCA Medicaid Managed Care Liaison will :

• Coordinate health care services and benefits with the following : 1. 29-I VFCA Health Facilities treatment team 2.
• MMCP’s foster care liaison 3. LDSS’s managed care foster care liaison 4. Health care providers, including school and community-based services 20 VFCA HEALTH FACILITIES LICENSE GUIDELINES DECEMBER 2024
• Inform and coordinate with the MMCP when a child’s primary care provider needs to be changed
• Be the primary contact person for the MMCP to assist with the following : - MMCP enrollment, disenrollment, and transitions - Immediate issuance of a Welcome Letter - Securing identification showing the effective enrollment date (including immediate temporary identification)
• Replacement insurance identification card
• Assist with foster care placement changes including : - Access to health care - Facilitate a single case agreement when a child is placed outside of the MMCP’s service area or provider network
• Interact with clinical and billing staff
• Refer children for needed services and assist in provider selection
• Maintain eligibility for public or private health insurance
• Assist with consent and / or confidentiality issues
• Oversee all Medicaid business functions
• Assist with court ordered services and fair hearings Central to the VFCA Medicaid Managed Care Liaison role is communication, both internally and externally. The 29-I VFCA Health Facility will communicate with MMCPs using secure phone, fax, and email. The 29-I VFCA Health Facility will develop and implement a system of communication and notification with MMCPs that includes :
• Mechanisms for sending and receiving information, including new enrollments or dis-enrollments from MMCPs
• Foster care intake and discharge status
• Changes in placement or address
• Changes in health status or provider This system of communication will include the use of the Medicaid Managed Care Foster Care and 29-I Transmittal Form which must be used for any of the following situations within required timeframes

Minimum Requirements

Revised TMH 10 / 8 / 25