MRT Specialist

SUMMARY

*This position will be responsible for Washington and Nowata Counties.*

The Medicaid Response Team (MRT) Specialist is responsible for proactively assisting individuals receiving services through GRAND Mental Health with obtaining, maintaining, and restoring Medicaid eligibility. This position serves as the primary resource for clients identified as being at risk of losing Medicaid coverage by providing education, outreach, application assistance, documentation collection, and coordination with state agencies. The MRT Specialist works collaboratively with clinical and operational staff to minimize interruptions in healthcare coverage, improve continuity of care, and protect organizational reimbursement through timely Medicaid retention and reinstatement efforts.

The MRT Specialist utilizes agency reporting tools, dashboards, and standardized workflows to prioritize outreach efforts, monitor case progress, document activities, and achieve established program performance metrics.

EDUCATION

·         HS Diploma or GED

KNOWLEDGE, SKILLS, AND ABILITIES

·         Oklahoma Medicaid (SoonerCare) eligibility requirements, renewal processes, and application procedures.

·         Oklahoma Health Care Authority (OHCA), Department of Human Services (DHS), and community benefit resources.

·         Customer service principles and techniques for working with vulnerable populations.

·         Confidentiality requirements including HIPAA and agency privacy standards.

·         Electronic Health Records (EHR), Microsoft Office applications, and case management software.

·         Data tracking, documentation, and quality assurance processes.

·         Certified Community Behavioral Health Clinic (CCBHC) principles and integrated healthcare delivery.

·         Build rapport with clients experiencing behavioral health, substance use, and socioeconomic barriers.

·         Explain complex Medicaid eligibility requirements in language clients easily understand.

·         Prioritize large caseloads while meeting multiple deadlines.

·         Exercise sound judgment and problem-solving skills.

·         Coordinate effectively with multiple departments and outside agencies.

·         Maintain detailed documentation with a high level of accuracy.

·         Analyze reports to identify individuals requiring outreach.

·         Adapt quickly to changing Medicaid regulations and organizational priorities.

·         Work independently with minimal supervision while contributing positively to a collaborative team.

·         Maintain professionalism during difficult or emotionally stressful situations.

·         In addition, must possess skill in working cooperatively and effectively with clients, staff, management, and other professional groups; in exercising mature judgment in dealing with people; in presenting ideas clearly and accurately; in reading and comprehending the English language; and in communicating effectively, both orally and in writing; and maintaining strict confidentiality.

JOB DUTIES AND RESPONSIBILITIES

·         Monitor daily MRT dashboards and reports identifying clients approaching Medicaid renewal deadlines or who have recently lost Medicaid eligibility.

·         Conduct proactive outreach to clients 30 and 60 days prior to Medicaid renewal deadlines.

·         Assist clients with completing Medicaid renewals, SoonerCare applications, and reinstatement requests.

·         Gather, verify, and submit required documentation necessary for Medicaid eligibility determinations.

·         Coordinate with OHCA, DHS, Social Security Administration, healthcare providers, and other community partners to resolve eligibility barriers.

·         Track assigned cases from initial outreach through successful completion and document all activities within agency systems.

·         Educate clients regarding Medicaid renewal requirements, reporting obligations, deadlines, and available resources.

·         Collaborate with Integrated Team Managers, therapists, care coordinators, peer recovery support specialists, and other staff to ensure coordinated client support.

·         Escalate complex eligibility issues to the MRT Coordinator when additional intervention is required.

·         Maintain accurate records supporting agency performance metrics.

·         Participate in ongoing training related to Medicaid regulations, workflow improvements, and agency initiatives.