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ASD Benefit Support Specialist - Detroit, United States - Detroit Wayne Integrated Health Network
Description
The ASD Benefit Support Specialist is responsible for ensuring data integrity and the monitoring of consumer information in the MHWIN Consumer Charting System.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Connects necessary stakeholders to ensure eligible beneficiaries are enrolled and engaged in behavioral health services.
Assists in the referral, approval, transfer and disenrollment in the Autism Benefit Program.
Supports the ASD Benefit Team to ensure Medicaid ASD Benefit requirements are met.
Monitors the Autism Benefit email, ASD Physician Referral Form entries and outside Comprehensive Diagnostic Evaluation Report reviews for beneficiaries to determine qualifying screening and diagnosis, ensuring required documentation is received.
Coordinates with the Access Call Center regarding physician referrals that are received through the Autism Benefit email to schedule members for a comprehensive diagnostic evaluation appointment.
Retrieves caseload data and monitors data integrity and recruitment for NCQA.
Provides support to ensure data integrity of beneficiary information in the MHWIN Consumer Charting System and MHWIN.
Completes monthly Program Assignment Check to correct discrepancies and ensure data integrity.
Completes monthly Document Compliance Reports and compiles notice template.
Updates, disseminates and processes Provider Monthly Logs.
Completes case transfers and discharges between providers and Regions in the MHWIN System.
Monitors case status and provides technical support to providers as needed to ensure efficiency and quality.
Works closely with the ASD Program Administrator to ensure case coordination of beneficiaries in the Autism Benefit.
Forwards enrollment notices to provider contacts.
Reviews and corrects cases that are missing data in MHWIN or that are outside of Performance Indicators.
Coordinates with the Supports Coordinator and ABA Providers on cases, focusing on case outliers to ensure timely access and coordination of care.
Creates reports and updates as needed.
Provides on-going case monitoring and follow-up.
Assists in the Monitoring of Network ASD usage and tracks trends.
Attends DWIHN Resource Events to distribute information and answer questions related to accessing autism benefits.
Performs related duties as assigned.
KNOWLEDGE, SKILLS AND ABILITIES (KSA'S)
Knowledge of DWIHN policies, procedures, and practices.
Knowledge of the DWIHN provider network and community resources.
Knowledge of the Michigan Mental Health Code.
Knowledge of MDHHS policies, rules, regulations and procedures.
Knowledge of Federal policies, rules, regulations and procedures as it relates to DWIHN.
Knowledge of behavioral health and mental health principles and practices.
Knowledge of the Michigan Medicaid Provider Manual.
Knowledge of MHWIN.
Knowledge of the Medicaid ASD Benefit.
Knowledge of the field of mental health and specifically the field of Autism.
Organizational skills.
Time management skills
Organizational skills.
Planning skills.
Accuracy skills.
Coordination skills.
Computer skills (Word, Excel, Access, Power Point, Outlook, Teams).
Ability to communicate orally.
Ability to communicate in writing.
Ability to work effectively with others.
Ability to work with an ethnically, linguistically, culturally, economically and socially diverse population.
Judgement/Reasoning ability.
REQUIRED EDUCATION:
A Bachelor's Degree in a mental health, human service, social service or related field.
REQUIRED EXPERIENCE:
Two (2) years of full-time paid experience in the field of mental health, human services, or social services.
(Knowledge of Medicaid Autism Benefits is preferred)
REQUIRED LICENSE(S).
A valid State of Michigan Driver's License with a safe and acceptable driving record.
WORKING CONDITIONS
:
Work is usually performed in an office setting but requires the employee to drive to different sites throughout Wayne County and the State of Michigan.
Currently this position is primarily a remote position.
This description is not intended to be a complete statement of job content, rather to act as a general description of the essential functions performed.
Please Note:
DWIHN requires proof of being fully vaccinated for COVID-19 as a condition of employment. Medical or religious accommodations or other exemptions that may be required by law, will be approved when properly supported. Further information will be provided during the recruitment process.
The Detroit Wayne Integrated Health Network is an Equal Opportunity Employer
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