Personal Care Management Prior Authorization Liaison - Tempus Unlimited Inc.

Position Title: Personal Care Management Prior Authorization Liaison

Location: Tempus Corporate Headquarters, 600 TECHNOLOGY CENTER DR, STOUGHTON, Massachusetts, United States of America

Requisition Number: Req

Date Posted: Monday, October 7, 2024

Description: Tempus Unlimited, Inc. is a nonprofit organization that provides community-based services to empower children and adults with disabilities to live as independently as possible in the least restrictive environment. The agency, through its programs and services, encourages the inclusion of people with disabilities into the mainstream of society, including social, recreational, family and work activities.

Summary/Objectives

The PA department is responsible for the submission, tracking, extension and receiving of the PCA evaluation (Prior Authorization) with Mass Health. PA Liaison Associate level perform their jobs accordingly to Mass Health PCA Operating Standards.

Essential Functions

• Review and submit all evaluations to MH by following PCA Operating Procedures
• Notify consumer/surrogate and Skills Trainer of MH decision.
• Track all consumers by PA expiration and discuss extension with supervisor
• Follow-up on all supporting documentations, MD, and consumer/surrogate/LG's signature as needed.
• QA RN evaluations before submitting to MH.
• Maintains confidentiality of all Consumer/PCA information.
• Must report all suspected incidents of consumer sexual/physical abuse and neglect to the Disabled Person Protection Commission (DPPC).
• Train/assist in training new department employees
• Monitor SCO/One Care/CCM inboxes and retrieve authorizations from faxes daily
• Enter PA info into database for all new SCO referrals, re-referrals and transfers when notified by intake that file is complete.
• Review monthly EVs report from FI and update database as needed with changes in insurance/ programs. Send for authorizations when enrolled in one care.
• Assist other department as needed.
• Other duties as assigned by Supervisor.

Competencies

• Must display teamwork and commitment while performing daily duties.
• Must demonstrate initiative and discipline in time management and assigned completion.
• Excellent organizational skills for initiation and maintenance of efficient workflow.
• Regular and reliable attendance and time reporting.
• Excellent telephone manner and organizational skills.
• Able to operate a computer keyboard, mouse, and other office type implements to accomplish document imaging duties.
• Ability to work in a high production environment while maintaining close attention to detail.
• Ability to work independently.
• Must have experience working in an office environment

Required Education

• High School Diploma or equivalent education

Work Environment

• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

• The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• This job requires at various times, the following physical activities: sitting, reaching, carrying, walking, pushing, pulling and lifting, finger dexterity.

Travel

• No travel is required for this position.

Other Duties

Note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Work Authorization/Security Clearance

All offers of employment made by Tempus Unlimited are contingent upon satisfactory background check results. Pre-employment background checks will be conducted on all candidates that are offered a position at the agency in compliance with program policy as well as state and federal regulations. From time to time, these checks may be conducted on current employees to ensure compliance with all state and federal regulations and contracts.

EEO Statement

Equal Employment Opportunity is a fundamental principle at Tempus Unlimited, Inc. where employment from recruiting through the end of employment is based upon professional capabilities and qualifications without discrimination because of race, color, religion, sex, age, sexual orientation, veteran status, national origin, disability or any other characteristic as established by law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.

Job Family: Associate

Job Function: Non-Supervisor

Pay Type: Hourly

Hiring Rate: $20.00

Compensation details: 20-20

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