Full Time 40 hours Grade 051 Financial Case Management Responsibilities Position Summary: Counsels, guides, advises and provides outreach services to patients requiring public benefits including; Medicaid, Child Health Plus, NYS Marketplace Exchange or other public entitlements. Accountable for coordinating all activities and necessary documentation needed to secure appropriate benefits. Resolves complex problems related to this process. Shares expert public benefits knowledge by providing consultation to physicians, social workers and other Health System staff whose patients require benefit assistance for payment and discharge planning. Typical Duties: Benefit Management: Provides outreach services to patients referred by University of Rochester Health System staff through face to face interaction, telephone contact and home visitation for patients requiring assistance with benefit application. FCMs apply for benefits via computer systems and/or paper application and may accompany or represent the patient at eligibility interviews, case conferences or fair hearings. Referral Coordination: Responsible for assessing referrals to determine eligibility for potential benefits and develops a plan of action to secure each. Communicates, coordinates and develops professional relationships with internal departments: Financial Counseling, Social Work, Patient Accounts, Financial Assistance Program, CIVU, Office of Counsel and Clinicians, External coordination includes families, community physicians, Department of Social Services, Social Security, Veteranâ™s Administration, Homeland Security, advocacy groups and other agencies. Problem Resolution: Identifies barriers to securing public benefits which may impact hospital reimbursement and timely discharge. Consults with FCM II, FCM III, or Associate Director to develop, coordinate, and implement plans to successfully resolve barriers. Monitoring Caseload, Documentation, and Reports: FCM monitors caseload and is responsible for accurate and timely documentation in requisite systems: Medicaid Database, Flowcast, Marketplace and OnBase scanning. FCM reviews productivity reports and prepares status updates as required by management. Continuing Education: Attends seminars and reviews Federal and NY State regulations, UR Medicine mandatory training requirements, Marketplace Certificated Application Counselor Seminars, and literature to maintain expert knowledge of public benefit programs. Safety Precautions: Exercises professional judgment to determine whether or not a home visit is a safety risk. Keeps direct supervisor advised of planned visits and takes appropriate safety precautions. Operates a motor vehicle to transport self and client as necessary. Ensures all safety precautions are taken during vehicle operation. Adheres to safety precautions involving mask, gown and glove usage. Qualifications: Bachelorâ™s Degree in Psychology, Sociology, Social Work or Business Administration and 1-2 yearsâ™ related experience such as Medicaid as an Eligibility Examiner or Eligibility Supervisor; or an equivalent combination of education and experience. Specialized knowledge of public benefit rules and regulations preferred. Requires a high degree of professionalism; must be motivated, an excellent communicator and writer, possesses customer service skills and the ability to work independently in an interdisciplinary team environment. Must provide and maintain a valid NYS Class 5 Driverâ™s License. CAC Certification.
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