Title: Alternate Resources Benefits & Mam Coordinator

JOB ANNOUNCEMENT

TITLE: ALTERNATE RESOURCES BENEFITS & MAM COORDINATOR

EMPLOYER: ROCKY BOY HEALTH BOARD

SUPERVISOR: BENEFITS COORDINATOR

SALARY: NEGOTIABLE DEPENDING UPON EXPERIENCE

STATUS: REGULAR FULL-TIME

OPENING DATE: SEPTEMBER 22, 2016 CLOSING DATE: OCTOBER 6, 2016-4:30 P.M.

PROBATIONARY PERIOD: SIXTY (60) CALENDAR DAYS FROM INITIAL APPOINTMENT

MAJOR DUTIES:  Provides leadership and acts as an advocate for Indian patients for determining service eligibility for access to alternative resources of funding in compliance with the “Payor of Last Resort” status.  Works closely with Purchased Referred Care (PRC) program in obtaining necessary information and documentation for clients needing assistance because of denials.  Incumbent shall observe the rule of confidentiality in all manners relating to the Chippewa Cree Health Clinic patients and Medicaid/Medicare applicants.  Assists individuals in preparing and retrieving documentation needed for accessing alternative resources for services eligibility.  Assists individuals in identifying the specific services that will improve the health care quality of the individual.  Assists the individual in collecting and submitting all paperwork required by other resource agencies and to establish and maintain contacts who can provide help in this process.  Assists the individuals in the appeals process if requests are denied and whether or not to appeal decision.  Attends the weekly PRC meetings and providing input as to what the status of patients’ alternate resources.  Also to determine why request was denied due to lack of information, collecting requirements, etc., and address appropriately for appeal.  Follows up on all pending eligibility claims and works closely with the families and agencies to see that the Indian patient is not discriminated against because of their dual role as a citizen and as an Indian recipient.  Develops schedule to assist recipients, taking into account recipient needs, program policy, capabilities, geographic location, time considerations, recommendations, collaborating with public and private sectors to assure appropriate recipient coverage by requirements.  Will be responsible for and will identify the employees and contractors that will participate in the tribal MAM (Medicaid Administrative Match) program.  These individuals will be required to participate in the MAM time study.  Will prepare electronic data file, coordinate training participation for those individuals completing the study.  Serves as a liaison for the Rocky Boy Health Center and other medical providers, hospitals, North Montana Medical Group formerly known as Havre Clinic being principle contact for agencies regarding alternative payment/service resources.  Makes visits to inpatient clients at N.M.H. for any assistance they may need or to observe patient treatment with follow up documentation as necessary.  Maintains a Medicare list on a monthly basis for the Part B reimbursement program. Submits payment request for the Medicare Premium. Collection Center for payment of Part B for participants who are not on the monthly reimbursement list.  Register 65 years olds for the Medicare state with the Social Security Administration. Keeps an ongoing list to be submitted for reporting.  Other duties as assigned by supervisor, Division Chief, Chief Executive Officer.

MINIMUM QUALIFICATION:  Must have a high school diploma or equivalent.  Must have excellent organizational skills, great flexibility, and be able to handle continuous changes in patterns, caseload, responsibilities, etc., on a daily basis with frequent interruptions.  Must be able to utilize general office equipment, such as all typewriters, copies, computer terminals, and printers.  Must have a high level of interpersonal skills required in order to effectively evaluate recipient needs, capabilities, and form a viable match for best possible resources.  Must have the ability to evaluate situations as they arise, making arrangements for resolution in the most equitable fashions for all parties involved.  Must be able to prioritize assignments/contacts.

DESIRED QUALIFICATIONS:  B.A. in related field

Other Selection Criteria:  Qualified Chippewa Cree members who are honorably discharged veterans will be given preference. DD214 required.  Chippewa Cree Tribal Preference.  Will be subject to pre-employment and random drug testing.  If terminated from any positions within the Chippewa Cree Tribe for violations of the Drug and Alcohol Ordinance I-99, must have completed requirements of the ordinance and submit follow up.  Only those applications properly completed and received on or before the closing date will be considered for the position advertised.  Applicants who meet the required qualifications described above will be further evaluated to determine the extent to which their education, work related experience, training, awards, professional recognition and supervisory appraisals indicate they possess or have the potential to acquire knowledge, skills, and abilities (KSA’s) required to perform the duties and responsibilities described above. On a separate sheet of paper discuss how you performed or have potential to develop the particular knowledge, skill or ability listed below. Failure to submit written responses as part of your application may result in an ineligible rating or substantially lower score.

Knowledge, Skills and Abilities (KSA’S): 1. Ability to submit weekly reports of breakdown of activity done to the Alternate Resource Benefits/Medicaid Eligibility Supervisor/Finance Manager/Chief Executive Officer that identifies the names and progress status of the clients who(m) are currently being assisted with their application(s). 2. Ability to provide assistance to the PRC program by assisting potential third party eligibility for clients to save on PRC funds. 3. Ability to work closely with the Social Security Administration/clients, other Tribal Social Services Programs identifying Medicaid clients on a daily basis for the benefit of their access to healthcare. 4. Will coordinate, manage, maintain the Medicaid Administrative Match Program. 5. Identify all Medicare clients and assist in maintaining their health coverage. Maintain the clients by list. Identification will be made for various reimbursement programs made available to the client. 6. Knowledge of the Privacy Act and HIPAA.

Candidates must submit the listed items:  Letter of interest/cover letter  Diploma or Official Transcripts, showing degree  Resume and application  Three (3) current letters of Reference  Proof of Tribal Enrollment, if applicable  Proof of Veteran- Honorable Discharge, if applicable  Knowledge, Skills and Abilities listed above

Submit to: Geri Racine, Human Resources Offr and/or Taunia Racine, Human Resources Assoc. Rocky Boy Health Board R.R.1 Box 664 Box Elder, MT 59521 Telephone (406) 395-4486

S______Jessica Windy Boy, CEO Date