TITLE: DESK REVIEWER - LONG TERM CARE ACCESS (LTCA) DEPARTMENT
DEFINITION: Under the supervision of an Assessment Worker Supervisor, this position is responsible for utilizing annual redetermination data for Functional Eligibility Determination (FED) assessments completed by Service Coordinators at the Managed Care Organizations (MCOs) to determine and ensure continued program eligibility for Community Health Choices (CHC) as well as recognizing any significant data change prior to the annual redetermination.
QUALIFICATIONS:
Education and Experience:
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High School Diploma or equivalent required.- College credits preferred.
- Experience in social services and computer applications preferred.
Personal Characteristics:
- Extremely organized and detail-oriented with the ability to multi-task.
- Excellent verbal, written communication, and administrative skills
- Strong computer skills including but not limited to Microsoft Office and database systems.
- Ability to quickly acquire needed knowledge.
- Ability to manage a high volume of data and paperwork with maximum level of productivity.
WORK LOCATION:
This position may be hybrid (combination of in the office and remote) and/or work remotely with occasional in-office time required at the discretion of management.
Additional Requirements:
- Pre-employment physical.
- Drug testing.
- Criminal history clearance.
- High level of computer proficiency.
DUTIES AND FUNCTIONS:
- Review a minimum of 50 Desk Review alerts per day using the Desk Review criteria set by Aging Well.
- Identify Desk Review alerts that meet criteria and complete documentation in data system. Consult with Aging Well Quality Compliance and Supports Manager (QCSM) if there are any questions on whether a Desk Review should be completed.
- Maintain a Desk Review Tracking sheet for alerts that meet criteria for documenting required information on the sheet. Forward completed sheet weekly to the supervisor.
- Identify alerts that meet the priority criteria and complete a Desk Review template to attach in consumer’s data record and send a priority alert via email to the QCSM.
- Ensure all Desk Reviews completed are submitted and not left in progress prior to the end of the working day.
- Complete a comprehensive End of the Day report that reflects priority cases, discrepancies, cases where more than one Desk Review was completed, and desk reviews that were unable to be completed.
- Attend staff, team, and in-service department and agency meetings as required.
- Performs other duties as assigned.
