SUMMARY DESCRIPTION:   The Cal AIM Data Analyst supports Cal AIM operations and billing.

 

Cal AIM duties   

• Maintain the ECM Outreach tracker.


• Complete monthly OTF and RTF reports.


• Check outreach contacts for billing monthly.


• Receive and download information from a variety of Managed Care Plans (MCP) portals


• Track authorizations received.


• Request re-authorizations from MCP’s.


• Manage information from the two data bases LSS utilizes: Simply Connect and Apricot.


• Liaison with Billing/Authorization/Referral point of contact with MCP’s.


• Upload Service Plans and Releases into MCP portals.


• Enroll new referrals into Simply Connect.


• Refer new enrollees to LSS Outreach Specialist.


• Manually request authorizations from MCP’s Health Net and Partnership.


• Disenroll clients through MCP portal.


• Case Load analysis.


• CS and ECM Capacity Reports monthly.


• Respond to requests to audit documentation from MCP’s.


• Maintain the master referral log of LSS direct referrals (from Apricot).


• Facilitate LSS requests for additional services.


• Case Load clean-up.


• Report case load size in weekly Cal AIM meeting.


• Maintain Intranet.

 

 

 

Administrative Support:

• Retrieving messages and forwarding via voice mail, written messages and/or email to appropriate personnel. Messages will be processed and calls will be returned within 24 hours.


• Receive, sort and route incoming and outgoing mail, facsimiles, packages and other deliveries.


• Operate and maintain all office equipment and assist users as needed.


• Maintain an adequate inventory of office supplies; order and receive assist purchases as necessary.

 

PHYSICAL DEMANDS:  The physical demands described here are representative of those that must be met by an employee to successfully perform the essential function of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee frequently is required to use hands to hold objects, writing instruments, or files; and talk and hear. The employee is frequently required to stand, walk, sit, and reach with hands and arms, to use a computer and smell. The employee must occasionally lift/or move up to 10 pounds. Specific vision abilities required by this job include ability to read, close vision, distance vision; color vision, peripheral vision, depth perception, and the ability to adjust focus. This position requires the ability to see, review and share the organizations secure electronic and physical files with other program staff; the incumbent will also have access to the organization’s and other highly confidential information. Because of this, the employee must have the ability to perform the job at the location of the assigned program or field office(s).

 

The employee occasionally will be required to drive to travel to locations within the regional areas of LSS. The employee may on occasion help the client navigate government, education, health care and other social service systems. This may require standing in lines, walking up and down multiple steps and driving and transporting clients to multiple destinations on any given day. While performing the duties of the job, the employee may occasionally work outside in weather conditions, is exposed to vibration while driving a car.