PRC Manager / PD

SUMMARY

Administers and coordinates the Purchased Referred Care (PRC) Services Self-Governance Compact Health files, Forest County Potawatomi Portal, Resource Patient Management System (RPMS), software systems relevant to position as needed, and act as liaison between clients, providers, and Third-Party Administrator. This position will perform the duties of the Program Director for Purchased / Referred Care Services. In addition, this position will include Tribal Premium Sponsorship Program responsibilities, Benefits, CHR budget and PRC Transport responsibilities. Plan for TPA to FPA. Excellent customer service a must.

MINIMUM QUALIFICATIONS

• Bachelor's Degree in Health Administration or equivalent education and experience.
• Minimum of and Associates Degree and five (5) years of experience in Purchased Referred Care.
• Minimum of five (5) years of experience with Health Database and Financial budget management skills
• Must have a valid unrestricted driver license and be insurable by the GTB insurance carrier.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Assist in determining eligibility in the Tribal Premium Sponsorship Program and work with client(s) to apply for Sponsorship, working collaboratively with the Benefits Coordinator and other Department Staff. Must train and pass to become Certified Assistor through the Marketplace Learning Management System (MLMS) with Center for Medicare and Medicaid Services (CMS).

OTHER SKILLS AND ABILITIES

EDUCATION and / or EXPERIENCE

Must have completed Program Director Training or complete within one year of hire.

SUPERVISORY RESPONSIBILITIES

The Purchased / Referred Care staff, Benefits Coordinator and Transporters

EQUIPMENT TO BE USED

General office equipment including but not limited to computer, copier, calculator, fax machine, and telephone.

TYPICAL PHYSICAL DEMANDS

Travel throughout the six-county service area required. Requires sitting, lifting, reaching and walking. Some lifting of small office equipment up to 25 lbs. Also requires manual dexterity to operate office equipment.

TYPICAL MENTAL DEMANDS

The employee uses judgment in identifying and selecting the most appropriate procedures to use, or in determining which of several established alternatives to use. Deadlines are involved so there is time pressure on occasion.

WORKING CONDITIONS

A good deal of work is performed in an office setting. Working at GTB Satellite locations is required and the expectation is there may be travel within the six-county service area.

COMMENTS

Native American preference will apply. Must be willing and able to pass a background investigation and a drug and alcohol urinalysis as a condition of employment. Adherence to strict company policy regarding confidentiality is a must.

The above statements are intended to describe the general nature and level of work performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Management retains the right to add or to change the duties of the position at any time.

This position is subject to IC3 Background Investigation, Drug Screen and Driving Record / Motor Vehicle Report (MVR).