Service Coordination Assistant III, El Paso Health

Job Summary
Responsible for processing authorizations and referrals for Long Term Services and Support (LTSS) benefits in accordance with the timeframes outlined by regulatory agencies (i.e. Texas Health and Human Services Commission (HHSC)).  Responsible for the methodical review LTSS authorization requests to confirm eligible benefits for members and to ensure the appropriate per member per month revenue is received by the health plan.  Requires consistent examination of HHSC’s LTSS technical systems and portals to verify a member’s LTSS service level.   Serves as a key resource in coordinating care for members, LTSS providers, nursing facilities and other payers.  Supports Service Coordinators in delivering Home and Community-Based Services (HCBS), as well as other Long-Term Care Services to members with disabilities or special needs. 

Skills
1. Strong interpersonal, verbal and written communication skills.
2. Strong problem-solving skills and collaborating with other professional and non-clinical staff.
3. Ability to interpret policies and procedures and communicate complex topics effectively.
4. Effective communication skills with a diverse audience to include customers, providers and vendors.
5. Excellent skills in researching and interpreting data.
6. Ability to understand complex situations and interpersonal dynamics to effectively handle escalated customer and co-worker needs.
7. Ability to create, copy, edit, send and save documents, spreadsheets and correspondence utilizing Microsoft Word, Microsoft Excel and Microsoft Outlook.
8. Must be able to navigate a PC to open applications, send emails, and conduct data entry.
9. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and members/families.
10. Great attention to detail.
11. Ability to multitask, prioritize and manage time efficiently.
12. Bilingual, English and Spanish (written and verbal) highly preferred.

Work Experience
Three years of healthcare experience is required, preferably in a managed care environment in related area of responsibility, i.e. long-term care, home health, hospice, public health or assisted living.  Knowledge of Texas Medicaid and health plan processes preferred.  Knowledge of medical terminology preferred.  Experience as a case management support Associate, in a medical office or health plan preferred.  Strong knowledge of the MS Office suite (Microsoft Excel, Word and Power Point programs) is required.

License/Registration/Certification
Completion of the On-Demand LTSS Authorization Technician certification required within one year of being in the position.
Community Health Worker (CHW) certification required within one year of being in the position.

Education and Training
High school diploma or equivalent is required.  Associate degree is preferred.