Job DescriptionThe Transportation Specialist is responsible for coordinating transportation benefits and services for identified member populations and managing vendor relations to monitor and ensure performance levels, member experience, network adequacy, reporting compliance and contract outcomes. This role will oversee the trip approval process and any validation of member trips associated with the approval process. Regular reporting of transportation outcomes will be aggregated, monitored and reported accordingly.
- Utilizes information received from healthcare provider, member, or family to coordinate appropriate Non-Emergency Medical Transportation (NEMT).
- Utilizes knowledge and understanding of facility and/or network contracts and billing arrangements related to NEMT to monitor and ensure performance levels are met.
- Monitors response times to nonemergency ambulance calls with a goal of maintaining the highest possible on time reliability.
- Ensures successful communication with providers, care coordinators, vendor management and vendor dispatch teams to ensure on time performance and quality customer service.
- Responsible for generating timely and accurate reports.
- Applies working knowledge of all company policies, procedures, rules, regulations, and memorandums.
- Serves as liaison between vendor and organization with the support of the vendor oversight team.
- Manages all billing and invoices from vendor, including validation of eligibility and trip reports.
- Maintains and provides oversight of all NEMT policies and procedures.
General Job Information
Job FamilyOperations Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date1/6/2020
Date Requisition Created1/3/2020
Work ExperienceHealth Plans, Managed Healthcare, Network
EducationBachelors: Healthcare Administration (Required)
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- Bachelors degree in Health Services or related field.
- Strong verbal, written and interpersonal communication skills.
- Familiarization with medical and other related verbiage, local geography, emergency clinical practices, procedures and protocols required.
- Strong working knowledge of Microsoft Office Product Suite, as well as care management and claims systems.
- Ability to provide clear and concise directions and instructions.
- Demonstrated experience in creating and maintaining excellent working relationships with vendors, providers and peers.
- Must understand Medicare, Medicaid benefits and be able to quickly learn the health plan Model of Care.
- Thorough knowledge of long term services and supports and state contract language strongly preferred.
- Management experience in program and policy management.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.