Health Care Advocate

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General Description:

The Health
Care Advocate, as part of the Independent Consumer Advocacy Network (ICAN), the
New York State Ombudsprogram for Managed Long Term Care, will assist seniors
and people with disabilities as they transition into and navigate Medicaid
Managed Long-Term Care (MLTC). The Advocate will work with consumers to
resolve issues with their MLTC plans.

Reports to: Director
of Services

Duties and Responsibilities:

  • Provide
    direct in person consumer assistance, advocacy, and education for MLTC
    participants/caregivers by explaining enrollment and disenrollment,
    benefits, coverage and access rules and procedures, member rights and
    responsibilities, and appeals. Information will also be provided through
    distribution of written material.
  • Answer
    a live legal helpline during assigned shifts.
  • Assist
    participants/caregivers with raising and resolving quality of care and
    quality of life issues. Train other community-based organization advocates
    on these and other issues, and prepare do it yourself template materials
    for participants/caregivers to use.
  • Assist
    participants/caregivers with accessing records from the Managed Long-term
    Care plans.
  • Explain
    the grievance and appeal process and assist participants/caregivers in
    resolving problems and issues using skilled negotiation techniques and
    providing assistance in filing grievances and appeals when informal
    problem resolution proves unsuccessful.
  • Provide
    consumer outreach and education presentations at other community-based
    organizations and to participants/caregivers and advocates. Assist with
    developing and maintaining an outreach and education campaign.
  • Comply
    with all legal requirements established by NY State Department of Health
    for obtaining consent, ensuring access to records, coordinating contacts
    with plans, coordinating referrals, and for ensuring confidentiality, and
    protect against inappropriate disclosures of identifying information.
  • Ensure
    all significant client data and service provision details are current and
    accurate, and that they are documented in a timely manner into CIDNY’s and
    the contracted provider’s databases.
  • Maintain
    established quality assurance procedures. Conduct quality assurance
    reviews of cases, using case notes and information reports in the database.
  • Attend
    Agency’s in-service training and unit meetings as well as any other
    agency-related activities. Conduct trainings regarding client education,
    navigational and appeal services, consumer rights and responsibilities.
  • Identify
    systemic trends or practices that affect people with disabilities and
    seniors and work closely with other stakeholders to design a systematic
    response.
  • Assist
    in preparation of reports concerning the program.
  • Research
    as required.
  • Other
    responsibilities as identified by Supervisor.

 

 

Qualifications:

Education and/or experience required:

  • Must
    have earned a JD and be admitted to the practice of law in NY or pending
    admission
  • Demonstrated
    experience providing assistance to people with health insurance and health
    care access issues.
  • Previous
    work with the disability community or personal experience with disability
    a plus.

Skills, Licenses, and/or competencies
required:

  • Knowledge
    of health care coverage information, eligibility rules, and resources;
  • Understanding
    of social service delivery systems and government/benefits resources
    including laws and polices related to Medicare and Medicaid;
  • Excellent
    advocacy, interpersonal, organizational, and communication skills required;
  • Individual
    must have time management skills to maintain individual/community
    outreaches, caseload, documentation and administrative requirements;
  • In
    addition, the ability to work well independently as well as part of a
    team;
  • Must
    be computer literate of basic Microsoft Programs; knowledge of Salesforce
    a plus;
  • Familiarity
    with the Americans with Disabilities Act preferred.
  • Respectful
    and comfortable with persons from different cultural and socio-economic
    backgrounds.
  • Ability
    to speak a language other than English strongly preferred. 

Salary:  $62,000 + Excellent Benefits Package

We conform
to all laws, statutes, and regulations concerning equal employment
opportunities and affirmative action. We strongly encourage women, minorities,
individuals with disabilities and veterans to apply to all of our job openings.
We are an equal opportunity employer and all qualified applicants will receive
consideration for employment without regard to race, color, religion, gender,
national origin, disability status, genetic information and testing, family and
medical leave, sexual orientation and gender identity or expression, protected
veteran status, or any other characteristic protected by law. We prohibit
retaliation against individuals who bring forth any complaint, orally or in
writing, to the employer or the government, or against any individuals who
assist or participate in the investigation of any complaint or otherwise oppose
discrimination.

How to Apply:

Please
send a thoughtful cover letter and resume to Paige Munson, Director of
Services. Please use the job title as the email header.

 

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