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ITU Tribal Liaison, Managed Care - Albuquerque, United States - Molina Healthcare
Description
Molina Healthcare is in search of an I.T.U. Tribal Liaison, specifically with in-depth knowledge of Managed Care. Candidates for this role must reside within the state of New Mexico and be open to state-wide travel. We are also seeking someone who has a great deal of experience working with Tribal organizations. Highly preferred candidates will speak one of the New Mexico Native American dialects.This critical position will assist Molina Healthcare in promoting Native American's access to healthcare coverage and educate communities about the general and value-added services provided by Molina Healthcare.
You will be responsible for building and maintaining relationships with tribal community leaders, community-based organizations and providers within tribal lands and reservations through a combination of direct and indirect outreach and engagement activities directed toward building enrollment for all Health Plan lines of business.
You will also establish formal working relationships with and act as a central point of contact to the Indian Health Services (IHS) facilities and tribal 638 facilities.
This will be done in many ways, including interacting with other Molina Healthcare departments to improve services provided to Native American members, prospective members, IHS and tribal 638 providers.
Additional you may help support Molina Healthcare's relationship with IHS and tribal 638 facilities and establishes relationships with tribal employersAdditional Responsibilities:
In-state travel required.
Responsible for continuous quality improvements regarding member engagement and member retention.
Represents Member issues in areas involving member impact and engagement including:
Appeals and Grievances, Member Problem Research and Resolution, and the development/maintenance of Member Materials.
Develops liaison engagement strategy to maximize growth opportunities for the Health Plan.
Establishes and maintains relationships with assigned providers in tribal communities including Provider outreached (Indian Health Services and 638 Clinics).
Achieves net growth goals by assigned territory; measures and tracks productivity.Develops community and school outreach strategies including school-based engagement with key tribal schools; measures and tracks program results.
Identifies effective engagement opportunities through key Tribal Governments and TCBOs; measures and tracks results.
Serves as primary point of contact to the Native American Community, and other representatives as appropriate.
Holds semi-annual meetings with Native American representatives from around the State that represent geographic and member diversity. Minutes of such meetings shall be transmitted to the HSD/MAD within thirty (30) days of such meetings
Makes documented efforts to contract with the appropriate urban Indian clinics, Tribally owned health centers, and IHS facilities for the provision of medically necessary services.
Ensures that translation services are reasonably available when needed, both in providers' offices and in contacts with the contractor.
Ensures appropriate medical transportation for Native American members residing in rural and remote areas for members.Ensures that culturally appropriate materials are available to Native Americans.
May require specialized skills such as claims or billing
#LI-TR1
Job QualificationsRequired Education:
High School Diploma or GED
Preferred Education:
Bachelor's Degree preferred
Required Experience:
3-5 years' experience in healthcare industry, preferably in the Medicaid Managed Care Programs
Previous healthcare marketing and/or grassroots/community outreach experience
Preferred Experience:
Experience in the Medicaid Managed Care Programs
Experience with behavioral health and/or coordination of Long-Term Services preferred
Required License, Certification, Association:
Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.
State Specific RequirementsFor the state of Washington: Tribal Liaison may also serve as role of Indian Health Care Compliance Manager in partnership with corporate Molina compliance and will be responsible for monitoring compliance that apply expressly to IHCPs and AI/AN Enrollees (also in partnership with corporate compliance) and under authority of executive leadership.
To all current Molina employees:
If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Key Words:
Native American, Indian Health Services, IHS, Advocate, AI/Ans, Tribe, Tribal Health, Urban Indian Health Programs, Federal Health Care Systems, Complex Health, Liaison, Tribal Liaison, Taos Pueblo, Northern Tiwa, Picuris Pueblo, Ohkay Owingeh, Rio Arriba, Santa Clara Pueblo, Jicarilla Apache Nation, San Ildefonso Pueblo, Nambe Pueblo, Bi-Lingual, Pojoaque Pueblo, Tesuque Pueblo, Cochiti Pueblo, Santo Domingo Pueblo, Sandoval, Keres, NAEIP Program, San Felipe Pueblo, Santa Ana Pueblo, Sandia Pueblo, Zia Pueblo, Jemez Pueblo, Isleta Pueblo, Bernalillo, Isleta Pueblo, Valencia, Acoma Pueblo, Cibola, Laguna Pueblo, Zuni Pueblo, McKinley, Zuni, Mescalero Apache Tribe, Otero, Mescalero, Ft.
Sill Apache Tribe, Luna, Ft.Sill Apache, Navajo Nation E-Bernalillo, Cibola, Socorro, Rio, Arriba, McKinley, San Juan, Indigenous, Reservation, Sovereignty Pay Range:
$40, $88,511.46 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
