STAR+PLUS Service Coordination MNLOC Admin - Community Health Choice

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Job Summary:

The Service Coordination MNLOC Admin is responsible for assisting the Service Coordination
staff with the submission and tracking of assessments, communications, and documents
relating to the STAR+PLUS waiver program, as well as other special programs to HHSC, TMHP,
and HHSC Program Support Unit. The MNLOC Admin will also coordinate with members and
medical providers to obtain physician signature and other supporting documentation needed
for HCBS Waiver programs. The MNLOC Admin will also assist the Service Coordination staff
to track the due dates and Individual Service Plan dates for members enrolled in the HCBS
program or being assessed for the HCBS program.

Reports to Position Title: Senior Director, Health Services, LTSS

QUALIFICATIONS:

Required:

• Education/Specialized Training/Licensure:High School Diploma or GED required
• Work Experience (Years and Area):1 years of experience in a healthcare/managed care setting. Experience working with applicable state, federal, and third-party regulations required.

Preferred:

• Associate degree, Bachelors Degree in Healthcare Administration, Public Health, or related field preferred.
• Medicare/Medicaid population experience preferred.

Software Proficiencies: Microsoft Office (Word, Excel, Outlook)
Other: Able to work independently under general instructions.