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Program Support Coordinator

Company Name:
Fallon Health
About Fallon Community Health Plan:
Founded in 1977, Fallon Community Health Plan is a nationally recognized, not-for-profit health care services organization. From traditional health insurance products available throughout Massachusetts for all populations, to innovative health care programs and services for independent seniors, FCHP supports the diverse and changing needs of all those it serves. FCHP has consistently ranked among the nation's top health plans, and is the only health plan in Massachusetts to have been awarded "Excellent" Accreditation by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit .
Position Overview:
Assists the Program in communicating membership rosters and other reports as requested. Fully responsible for integrity of data related to Program rosters. Works with Data Analyst to coordinate potential member rosters and distributes new member/enrollee cases to Team per department workflows. Updates rosters based upon clinical need and available data.
Successfully handles multiple projects at the same time
Has frequent contact with program staff, members/enrollees, vendors, and other FCHP personnel on matters requiring tact and good knowledge of department policies
Performs duties and assists director/manager in administrative functions to relieve him/her of many time-consuming details including but not limited to: processing invoices from Program Vendors, calendar management, and other tasks as requested.
Demonstrates a systematic approach in managing multiple projects and duties related to Program development, growth, and expansion
Program Support:
Receives new enrollee/member files from various contacts including but not limited to: Department Operations Manager, Enrollee Service Representatives, Data Analyst, and others as appropriate
Processes (including logging/data entering and other steps per workflow processes) new incoming referrals/enrollees in the Department Access Database
Works with the clinical team leadership and routes/assigns new NaviCare enrollees to the appropriate Team members
Logs Minimum Data Set Home Care Forms into the Access Data base and scans into the NaviCare Centralized Enrollee Record
Prepares and distributes monthly NaviCare panel reports to the Navigators, Nurse Case Managers, Aging Service Access Points, Assisted Livings, and other facilities/providers as per workflow, saving master reports in the secure data file
Utilizes multiple software programs (including but not limited to case management platform, access data base, core system and others as appropriate)
Updates data bases with enrollee specific data including but not limited to: enrollment termination and transfer to other Programs as notified by Team members and/or reports
Documents work activity per department processes
'Triages' incoming calls from callers about Program enrollment
Informs team members about incoming calls and ensures team follows up on calls as appropriate in a timely manner ensuring optimal customer service
Processes department outgoing member/enrollee and provider mail per established workflows in a timely and accurate manner
Participates in data analysis and processing for regulatory entities including but not limited to the Executive Office of Health and Human Services (EOHHS) and other entities including provider groups
Assists with the preparation of presentations about Program activity as requested by FCHP areas and other outside entities including but not limited to regulatory entities and provider groups
Coordinates and maintains up to date Team Member/Member Assignment lists and any other lists and resources for the department such as phone rosters and resource materials
Organizes, maintains and updates Department share drive to ensure data is easy to find. Provides resource information and education to Team members on where to find documents in Department share drive
Ensures Program materials Team members mailed out to Enrollees by the Team is appropriately approved by the FCHP Communications Department and an adequate supply is available at all times
Processes NaviCare Program invoices per Department and Company processes
Provides support to the operation of the Department Team as necessary including but not limited to:
Helping to ensure the adequate supplies, processing incoming/outgoing mail, assisting with preparation for various meetings. Etc.
Preparing expense reports for Team Members
Engages in extensive contact with all levels of personnel in a professional and confidential manner. Promptly and courteously receives visitors to department. Answers phone courteously and promptly and takes accurate phone messages
Other:
Assists Program Leadership in creating and meeting contingency plans for each step of the process to anticipate complications
Supports department colleagues, covering and assuming changes in assignment as assigned by Manager/designee
Strictly observes HIPPA regulations and the FCHP policies regarding confidentiality of enrollee/member information
Performs other responsibilities as assigned by the Manager/designee
Education: Minimum of High School diploma required; Associates Degree preferred
Experience:
Familiarity with medical terminology/coding and/or experience working in a clinical setting
Must be able to prepare spreadsheets including but not limited to: protected health information data and maintain organized and efficient databases
Must be able to determine when it is appropriate to use Microsoft products including but not limited to: Excel, PowerPoint, Word, Access, or Visio and be proficient in their use
Date: 2014-07-24
Country: US
State: MA
City: Worcester
Category: Administrative/Clerical

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