Administrative & Quality Assistant

GENERAL SUMMARY

The position supports the LTSS Care Coordination team in the following ways:

• Responsible for processing Long Term Services & Supports Community Partner (LTSS CP) Transitions of Care notifications and communicating with Care Teams so they may begin outreach to consumers.

• Process all incoming and out-going correspondences pertaining to the LTSS CP program.
• Responsible for processing new referrals and monitoring quality, accuracy, and data integrity of the LTSS CP program.

ESSENTIAL JOB FUNCTIONS

1. Be knowledgeable of and comply with all applicable state, federal and agency regulations, policies and procedures pertaining to elder and disability services and WestMass ElderCare’s mission.

2. Using an electronic notification platform, process all Transitions of Care episodes, including disseminating new episodes/status changes to Care Teams, and tracking timely completion of activities.

3. Enter all monthly LTSS referrals into the CareLogic database, to capture Point of Entry (POE), as well as entering referrals into other tracking systems for Care Team utilization.

4. Assist with processing LTSS Ad Hoc referrals including verifying program eligibility,

following up with referrers to verify missing information, and communicating with

ACO/MCOs to request assignment for identified referrals.

5. Assist in reviewing and reconciling reports for accuracy and completeness prior to

transmission to ACO/MCO partners.

6. Assist in processing incoming documents/reports from ACO/MCO partners and disseminating information to appropriate Care Team members.

7. Process all incoming and out-going documents for the LTSS CP program including printing & sending of consumer facing letters, as well as retrieving and/or scanning documents for upload into the electronic medical record in accordance with the WMEC documentation standards.

8. Keep LTSS materials stocked and organized for the LTSS staff to utilize for consumer facing visits.

9. Regular communication with LTSS Care Team members, Data & Quality Analyst and/or LTSS Program Director to assist with data maintenance as needed.

10. Responsible for monitoring and responding to inquiries in the LTSS CP general email box and reciprocating, redirecting and/or escalating matters as needed.

11. Provides back up to the LTSS Data & Quality Analyst on data/quality projects as requested by the LTSS Program Director.

COMPETENCIES

• Has the ability and the willingness to support the goals and policies of WestMass ElderCare.
• Clerical skills including: accuracy in communications, e.g., spelling, proper written formats, and typing skills; ability to operate office equipment, e.g., copy machine, fax machine, and computer; and has knowledge of record keeping.
• Minimum of three years of previous data analysis and management related work.
• Associates degree preferred. Demonstrated data management, medical billing and reimbursement, or electronic medical records experience may be substituted for degree.
• Possess strong analytical and critical thinking skills.
• Possess advanced knowledge of MS Excel, such as VLookup functions and other data match utilities
• Possess advanced knowledge of Virtual Gateway, CareLogic, Bamboo Health, Jiva and/or other relational databases and reporting functions preferred.
• Possesses working knowledge of MSWord and Windows.
• Ability to learn multiple database applications and use data to improve quality of the information.
• Possesses the willingness and ability to become familiar with appropriate information, regulations and procedures relative to related programs.
• Has the ability to learn software specific to WestMass ElderCare and/or specific programs related to Medicaid and Mass Health.
• Must be attentive to details.
• Must have the ability to be accurate with calculations.
• Possesses initiative and self-direction.
• Possesses the ability to effectively communicate verbally and in writing.
• Possesses the ability to organize, prioritize and work with minimal supervision.
• Has the ability to effectively cope with a variety of personalities and other stress provoking factors.
• Has the ability to interpret, understand and adhere to the regulations, standards and procedures as set forth by the Agency and Mass Health.
• Must be able to work effectively in a changing environment

SUPERVISORY RESPONSIBILITY

• No

WORKING CONDITIONS/PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Has the ability to operate a keyboard 80% of work time and to maintain concentration needed for accurate data entry.
• Has the ability to ambulate independently.
• Has the ability to successfully communicate with others in person and by phone.
• Has the ability to see and understand written words and to communicate with written word.
• Has the ability to work with multiple priorities and deadlines.
• Must be able to maintain regular attendance.

WORKING CONDITIONS

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• This is a full time, 35 hour per week position.
• Generally busy office area with times of numerous interruptions.
• Ability to work between the hours of 8:00am and 5:00pm, Monday through Friday.
• Position may involve lifting up to 20 pounds.

ACCOUNTABILITY

The LTSS Admin & Quality Assistant is directly accountable to the LTSS Program Director.

Job Type: Full-time

Pay: $19.00 - $21.00 per hour

Expected hours: 35 per week

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No nights
• No weekends

Work Location: In person