Network Service Representative jobs in South Dakota

JOB SUMMARY

Service/Program coordinators assist with daily intake and referral processes to set clients up for services, coordinating their in-home care needs in compliance with Federal/State Regulations and Managed Care Organization (MCO) program rules. They maintain and coordinate a caseload of clients enrolled in Medicaid programs and conduct regular check-ins on clients to update care plans if that client’s needs change.

JOB DUTIES

• Maintain and coordinate a caseload of clients enrolled in Medicaid programs
• Coordinate clients’ in-home care needs in compliance with Federal/State Regulations, Managed Care Organization (MCO) program rules, and contract requirements
• Assist with daily intake and referral processes to ensure positive business growth and development
• Promote cohesiveness in the office environment
• Support day-to-day operations and client advocacy
• Ability to meet position requirements with little direct oversight
• Collaborate with stakeholders regarding the delivery of services
• Effective written and verbal communicator
• Comply with applicable legal requirements, standards, policies, and procedures
• Demonstrate dependability
• Demonstrate effective problem-solving and decision-making skills
• Exhibit computer efficiency
• Handle complex service programs and special projects
• Market services to referral sources as needed
• Maintain necessary skills and knowledge to coordinate workflow
• Participate in professional development and training activities
• Prioritize and multitask effectively
• Provide excellent customer service to internal and external clients
• Represent the company at stakeholder meetings, health fairs, and provider fairs
• Enroll clients and employees in services, web portal, and EVV systems as needed
• Conduct necessary client assessments and home visits as required
• Bilingual preferred in various locations
• Answer and make phone calls and occasional video calls
• Other duties as assigned

QUALIFICATIONS

• Bachelor’s degree in the field of Social Work, Psychology, Counseling, Rehabilitation, Nursing, Sociology or Related Field preferred
• 1 year of previous experience working with individuals with disabilities or the elderly preferred
• Combination of education and experience

The incumbent typically works in an office environment and uses a computer, telephone and other office equipment as needed to perform duties. The noise level in the work environment is typical of that of an office. Incumbent may encounter frequent interruptions throughout the workday. The employee is regularly required to sit, talk, or hear; frequently required to use repetitive hand motion, handle or feel, and to stand, walk, reach, bend or lift up to 20 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.