Social Services Coordinator

Solis Health Plans, Inc.; Florida; On-site; USD 42,000 - 54,000; Full time

Benefits offered by this job

Full benefits package

401K plan with company match

Job summary

Solis Health Plans, Inc. is hiring a Social Services Coordinator in Florida to manage Medicaid-related caseloads under the Outreach Services Manager. You will help members apply for state and federal programs, pre-screen for QMB/SLMB/QI1/LIS and follow up with agencies to advance applications.

Strong communication, organizational skills, and bilingual English/Spanish or Creole are required. Join a growing team dedicated to accessible, person-centered care and compliance with CMS, AHCA, and HIPAA

Qualifications

• High School Diploma or equivalent required.
• Ability to communicate effectively with staff, members and providers.
• Knowledge of Medicaid regulations and eligibility processes is beneficial.
• Proficiency with Word, Excel and Outlook.

Responsibilities

• Conduct telephonic and mail outreach to members and prospects.
• Assist members to complete applications for Medicaid programs.
• Identify and pre-screen for QMB, SLMB, QI1 and LIS.
• Interview clients and plan programs to meet their social and emotional needs.
• Ensure CMS/AHCA and HIPAA compliance for forms and PHI.
• Coordinate with Dept. of Children and Families and SSA on applications.
• Maintain accurate inventory of cases and collaborate with Sales and Member Services.

Skills

Communication skills

Time management

Bilingual English/Spanish or Creole

Education

High School Diploma

Tools

Word

Excel

Outlook

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Doral, FL, US

2 days ago Requisition ID: 1549

Salary: $20.00 Annually

About us:

Solis Health Plans is a new kind of Medicare Advantage company. We provide solutions that are transparent, connected, and effective for both our members and providers. Solis was created with a desire to offer a more personalized experience throughout every stage of the healthcare journey. Our team consists of experts who take pride in delivering quality service. We foster a culture of collaboration and support, where success is shared, and every employee is valued.

Location: 9250 NW 36th St, Miami, FL 33178.

**BILINGUAL IN ENGLISH & SPANISH OR CREOLE IS REQUIRED**

Full benefits package offered on the first on the month following date of hire including: Medical, Dental, Vision, 401K plan with a 100% company match!

Our company has doubled size, and we have experienced exponential growth in membership from 2,000 members to over 25,000 members.

Join our winning Solis Team!

Position Summary:

Under the general direction of the Outreach Services Manager, the representative will apply working knowledge of the Florida Medicaid regulations and Social Security Administration to an assigned caseload in order to obtain and maximize, Qualified Medicare Beneficiary (QMB), Special Low-Income Medicare Beneficiary (SLMB), Qualify Individual (QI1), and Low-Income Subsidy (LIS).

Essential Functions and Duties:

• Conduct telephonic and mail outreach materials to members and prospects.
• Assist members to complete application for state and federal Medicaid Programs.
• Identify and pre-screen prospective members for the QMB, SLMB, QI1, and LIS.
• Interview clients and families. Coordinates and plans programs and activities to meet their social and/or emotional needs.
• Comply with government regulations in all areas of responsibility required, I.e. signatures on all forms for Medicaid and LIS.
• Follow up with the Department of Children and Families and Social Security Administration on Medicaid and LIS applications in a timely manner.
• Prioritize daily duties and adapt quickly to changing responsibilities.
• Maintain updated knowledge of existing and new regulations on Medicaid and Social Security.
• Assist members as well as prospects in person or on the telephone with questions or concerns.
• Maintain accurate and organize inventory of cases.
• Able to work with other departments such as the Sales, Case Management and Member Services.
• Adheres and ensures compliance with Risk Management Program policies and adverse incident reporting.
• Understands and interprets policies and procedures.
• Ensures the compliance of CMS/AHCA rules and regulations are being observed, as well as the HIPAA regulations as applied to PHI.
• Other duties as assigned.

Required qualifications:

• High School Diploma or equivalent combination of training and experience.
• Understanding the Social Service goals and objectives in the managed care environment
• Knowledge of computer software packages and operations, especially Word, Excel and Outlook.
• Able to communicate effectively in oral and written forms with internal staff, members, families and providers.
• Ability to work within set deadlines.
• Professional, high degree of accuracy, detail oriented, confident and flexible.

Required Languages:

Bilingual English & Spanish or Creole.

What set us apart:

Join Solis Health Plans as aSocial Services Coordinator and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference.