Aetna KS Medicaid EPSDT Coordinator in Overland Park, Kansas
Req ID: 51942BR
The EPSDT Coordinator is dedicated to the KanCare CONTRACT responsible for all KAN Be Healthy services and related issues, including but not limited to, all KAN Be Healthy Kids activities and EPSDT screening events. This position interfaces and coordinates with the Foster-Care Coordinator, Director of Care Coordination, the Member Advocate and other internal staff to ensure the delivery of all preventive screenings and to ensure delivery of appropriate treatment and follow up based on identified diagnoses. This position utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members in decisions related to achieving and maintaining optimal health status.
Responsible for coordinating well-care for children, developing and implementing member and provider outreach activities and monitoring outcomes related to EPSDT services
By assimilating health assessment data analysis, establishes a plan of care based on members health status/risks, education, and support needs
Partners with members to identify opportunities for integration into available internal/external programs
Using holistic approach consults with supervisors or others to overcome barriers with assisting members in meeting goals and objectives
Identifies and escalates quality of care issues through established channels
Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
Utilizing interviewing and active listening skills, provides coaching, information and support to empower the member to make ongoing independent healthy lifestyle choices.
Interprets and utilizes clinical guidelines/criteria to positively impact members health
Provides up-to-date healthcare information to help facilitate the members understanding of his/her health status
Helps member actively and knowledgably participate with their provider in healthcare decision-making
Develops and monitors established plans of care, in collaboration with the member and/or attending physician, to meet the members goals
Utilizes internal policy and procedure in compliance with regulatory and accreditation guidelines
-3-5 years relevant work experience and a bachelors' degree in health-related field
-Background in motivational interviewing, active listening skills, Transtheoretical Model, mindfulness based and other evidence-based coaching techniques preferred.
-Experience in facilitating patient/client positive behavioral change
-Ability to work with a multidisciplinary team
-Excellent computer skills including MS Office applications such as Excel, Word and Outlook.
-Demonstrated ability to communicate, problem solve, and work effectively with people, use good judgment in challenging situations
-Knowledge of state-specific and federal EPSDT requirements
-Develop member and provider education and outreach materials
-Analyze and interpret data related to EPSDT services
-Review and interpret the annual CMS 416 (EPSDT) report
-Collaborate with Case Management on children that require care for special needs
-Contribute to improvement of overall EPSDT and HEDIS related rates
-Critical and analytical thinking skills
-Report writing abilities
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Leadership/Fostering a Global Perspective/FOUNDATION
General Business/Communicating for Impact/FOUNDATION
Benefits Management/Encouraging Wellness and Prevention/ADVANCED
General Business/Applying Reasoned Judgment/ADVANCED
General Business/Consulting for Solutions/FOUNDATION
ADDITIONAL JOB INFORMATION
Areyou ready to join a company that is changing the face of health care across thenation? Aetna Better Health of Kansas is looking for people like you who valueexcellence, integrity, caring and innovation. As an employee, you ll join ateam dedicated to improving the lives of KanCare members. Our visionincorporates community-based health care that works. We value diversity. Alignyour career goals with Aetna Better Health of Kansas, and we will support youall the way.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
Job Function: Health Care