Consumer Coordinator (Social Worker)

Job description

RESPONSIBILITIES

· Comply with all HIPPA, State, and Managed Care Organizations regulations.

· Communicate with consumers, employees, and other individuals to answer questions, disseminate, or explain information, and address complaints.

· Compile, copy, sort, and file records of consumers.

· Operate office equipment, such as photocopiers, scanners, fax machines, voice mail systems, and computer systems.

· Responsible for keeping office well-ordered and clean.

· Responsible for submitting critical incident reports in a timely manner to all MCO's, as well as tracking and following up on submitted reports to remain in compliance.

· Auditing consumer files and following up with office staff to ensure files are complete and accurate.

· Auditing each branch office’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) files and following up with staff to ensure they are complete and accurate.

· Schedule all nurse visits for each branch office’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) in a timely manner.

· Oversee that supervisory visit reports are completed in a timely manner.

· Oversee the completion of consumer eligibility reports.

· Oversee the completion of growth and loss reports.

· Oversee the completion of Closure reports, MAD062 Forms.

· Offer information to members on the best course of action when faced with difficulties such as, Benefit Enrollment, Eligibility loss, and other like matters.

· Refer clients to community services that may be beneficial to them and their well-being.

· Monitor and address complaints to ensure consumer satisfaction.

· Communicate and work with all branch offices to reduce all hours not worked.

· Comply data from all monthly reports into a concise spreadsheet for upper management as requested.

Experience

· Proven experience in program development and management

· Strong administrative skills, including basic budgeting and program evaluation.

· Social Work Experience

· Experience working with individuals with developmental disabilities or similar populations.

· Experience working with data basis such as: Authenticare.

· Experience with New Mexico Medicaid and Medicare programs

· Experience managing and leading a team of 10 or more. 

· Experience with New Mexico programs such as, SNAP, WIC, TANF, LIHEAP, General Public Assistance

· Excellent interpersonal skills for relationship management

· Experience working with NM Medicaid Portals 

Skill Requirements

· Bilingual preferred

· Ability to build and maintain professional helping relationships.

· Ability to relate and communicate with diverse populations and groups.

· Proficiency with Microsoft Office applications

· Excellent listening and communication skills

· Time Management

· Leadership

· Teamwork

Note: This job description is not intended to be all-inclusive. Employees may perform other related duties as assigned to meet the ongoing needs of the organization.