Enrollment Coordinator

Position Summary

The Enrollment Coordinator supports the Care Connection Department by ensuring the integrity of ACA/NY’s data for all prospective members in the Electronic Health Record system as well as other database systems including OPWDD CHOICES. The Enrollment Coordinator is responsible for generating regular reports that will identify complex issues, uncovering root causes and patterns, and providing solutions that uphold ACA/NY’s quality standards and compliance requirements. The Enrollment Coordinator supports the overall required pre-enrollment tasks to ensure successful enrollment into ACA/NY.

ACA/NY is a 501(c)(3) not for profit organization that has been designated as a Care Coordination Organization/Health Home (CCO/HH) by New York State. ACA/NY is dedicated to meeting the needs of people with Intellectual and Developmental Disabilities by providing comprehensive care management and coordination of service. ACA/NY supports 25,000+ people in its program with support services spanning New York City, Long Island, and the Lower Hudson Valley.

Duties and Responsibilities

• Monitors the first of the month roster enrollment and follows up accordingly.
• Reviews, monitors, identifies, communicates and helps to facilitate corrective action as needed for potential errors and issues regarding ACA/NY’s Roster information (e.g. exceptions, missing CM assignment, new/dis-enrollments).
• Verifies quality and compliance of enrollments and processes enrollment requests (CCO1) from Assistant Directors of Admissions.
• Maintains data integrity by use of error checking methods, exception reports, audits, and validation procedures.
• Collects and reports on errors impacting data integrity.
• Performs data reconciliations to identify data anomalies.
• Creates reports when needed, identifies trends and recommends solutions to maintain roster integrity.
• Presents findings, and analyses in a clear, concise, and understandable format via reports, and to program leadership.
• Understands, interprets, and applies OPWDD and DOH regulations and ACA/NY policies; communicates and applies updates/changes in a timely way; keeps current on trends, anticipates implementation of pending rules.
• Translates ACA/NY policy and regulations and requirements into specifications that will be used to implement required reports.
• Serve as an expert in all facets of the Electronic Health Record system, including the enrollment roster and self-reporting functions.
• Coordinates and leads special projects and teams as requested by the Director of Admissions or Executive Leadership.
• Oversees and monitors the completion of documents as related to required documentation for enrollments at ACA/NY.
• Communicates and coordinates Medicaid checks with billing and the Care Connection Departments.  Notifies billing of CCO transfer for code changes.
• Responsible for completing Level of Care Eligibility Determination (LCED) re-determinations for new members (if applicable) at or around the time of enrollment to prevent any lapse in LCED.
• Attend meetings both internal and external as requested.
• Demonstrates the ability to manage workload and drive issues to closure in a timely manner with minimal supervision.
• Stays up to date on DOH and OPWDD policies related to disenrollment, updating Director of Admissions as needed.
• Establishes and maintains a community network between service providers.
• Attends all required training in accordance with Agency and Departmental policies and procedures.
• Attends and actively participates in departmental meetings.
• Serves as a mandated reporter by reporting incidences of abuse, neglect, and maltreatment, and follows ACA/NY OPWDD untoward incident reporting procedures.
• Adheres to standard safety practices of job, department, and Agency policies and procedures related to safety.
• Supports implementation of new modules and system upgrades.
• Perform other duties as assigned.

• Bachelor’s degree in a Health or Human Services field plus 2 years of relevant experience required. One of the two years’ experience must be experience working with people with I/DD; OR a master’s degree (in a health or human services field required- if bachelor’s is in another field of study) and one year experience working with people with I/DD. Proficiency with the use of excel and other software products used for tracking the flow of information. 
• QIDP designation required.
• Demonstrated fluency in data reporting software and experience using Microsoft Excel. 
• Experience using OPWDD’s CHOICES system, a plus. 
• Absolute sense of integrity and personal commitment to serving people with I/DD and their families. 
• Excellent interpersonal, communication organization and demonstrated ability to manage multiple tasks simultaneously. 
• Ability to work autonomously. 
• Demonstrate professionalism, respect, and ability to work in a team environment. 

Physical Requirements

While performing the duties of this position, the employee is regularly required to perform the following: Engage in verbal and written communication, operate a computer, smart-phone, and other office tools and equipment; travel between locations and within locations, stand, walk, sit, reach with hands and arms; stoop, kneel, and crouch, moving objects up to 25 pounds, and to visually or otherwise focus and navigate; ACANY will provide reasonable accommodation, in accordance with applicable policies and laws.

AAP/EEOC

ACANY provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, the organization complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, training, and all other legally protected classifications.