Medicaid Managed Care Liaison

Job Title : Medicaid Managed Care Liaison Job Description

Reports to: Administrative Director of Nursing- Health Services

Locations: Marian Hall, Brooklyn, EFFC Burnside (Bronx) (Various Locations

Hours : 35 Hours, Non- Exempt (Position requires to staff to be onsite. Hybrid schedules are at discretion of Program Leadership following probationary period)

Job Summary

Medicaid Managed Care Liaison (MMCPs) are responsible for ensuring there is a highly coordinated approach between Good Shepherd Health Services and the Medicaid Managed Care Plans (MMCPs). All 29-I VFCA Health Facilities are required to have a VFCA Medicaid Managed Care Liaison who will coordinate with the MMCPs. All MMCPs must have a Foster Care Liaison (FCL) who shall be the direct MMCP contact with 29-I VFCA Health Facilities, and work in collaboration with the MMCLs will for monitoring access to health care for children in foster care.

Responsibilities

The VFCA Medicaid Managed Care Liaison will:

• Coordinate health care services and benefits with the following: 1. 29-I VFCA Health Facilities treatment team 2.
• MMCP’s foster care liaison 3. LDSS’s managed care foster care liaison 4. Health care providers, including school and community-based services 20 VFCA HEALTH FACILITIES LICENSE GUIDELINES DECEMBER 2024
• Inform and coordinate with the MMCP when a child’s primary care provider needs to be changed
• Be the primary contact person for the MMCP to assist with the following: - MMCP enrollment, disenrollment, and transitions - Immediate issuance of a Welcome Letter - Securing identification showing the effective enrollment date (including immediate temporary identification)
• Replacement insurance identification card
• Assist with foster care placement changes including: - Access to health care - Facilitate a single case agreement when a child is placed outside of the MMCP’s service area or provider network
• Interact with clinical and billing staff
• Refer children for needed services and assist in provider selection
• Maintain eligibility for public or private health insurance
• Assist with consent and/or confidentiality issues
• Oversee all Medicaid business functions
• Assist with court ordered services and fair hearings Central to the VFCA Medicaid Managed Care Liaison role is communication, both internally and externally. The 29-I VFCA Health Facility will communicate with MMCPs using secure phone, fax, and email. The 29-I VFCA Health Facility will develop and implement a system of communication and notification with MMCPs that includes:
• Mechanisms for sending and receiving information, including new enrollments or dis-enrollments from MMCPs
• Foster care intake and discharge status
• Changes in placement or address
• Changes in health status or provider This system of communication will include the use of the Medicaid Managed Care Foster Care and 29-I Transmittal Form which must be used for any of the following situations within required timeframes
  
  

Minimum Requirements

• High School Diploma/GED Required. Associate Degree is preferable
• Must have experience with Medicaid Managed Care
• Must have experience, expertise, and knowledge of the child welfare system &foster care healthcare requirements
• Understanding of the unique complex needs of the foster care population
• Familiarity with Medicaid Managed Care policies and procedures
• Ability to clearly communication both in writing and verbally
• Proficient in Microsoft Office (MS Word & Excel) Outlook Required
  
  

Revised TMH 10/8/25