Enrollment Specialist

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Job Description

Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget.  We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services. 

Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve. (learn more at www.pplfirst.com).

Must reside in the state of Virginia.

Job Summary:

The Enrollment Specialist serves as the primary point of contact for participants, authorized representatives, and providers throughout the enrollment process for self-directed services programs. This role facilitates timely and accurate enrollment by coordinating required documentation, resolving enrollment barriers, collaborating with internal and external stakeholders, and ensuring compliance with program requirements. The Enrollment Specialist provides person-centered education and training on employer responsibilities, program rules, and financial management systems while assessing participants' ability to successfully self-direct services. Additionally, the role supports participant health, safety, and program integrity through ongoing documentation, monitoring, and reporting of suspected fraud, abuse, neglect, or exploitation in accordance with established policies and procedures.
 

Key Responsibilities:

Enrollment & Service Coordination

• Follows up on referrals for participant-directed services.
• Supports the individual/employer and their provider(s) in completing all necessary documentation required for enrollment.
• Identifies potential barriers and bottlenecks to timely enrollment and takes necessary steps to triage and resolve.
• Engages the entity providing case management or service/support coordination services to the individual to ensure timely coordination of service approval and authorization.
• Collaborates with internal and external stakeholders as necessary to ensure enrollment cycle times are minimized and the first payment to the provider(s) is received on time and in full.
• Performs all functions necessary to support the enrollment of the individual/employer/authorized representative and provider(s) including processing enrollment documentation, obtaining employer identification numbers, completing criminal background checks, and other enrollment related requirements.
• Communicates referral corrections, as needed, to entities providing case management or service/support coordination services to the individual.
• Updates enrollment status of individual participants and providers through portal and records in systems. In collaboration with the enrollment supervisor, supports workforce management delegation to ensure service levels are met.

Participant Assessment & Support

• Assesses Participant’s and/or authorized representative’s ability to communicate, acquire new information, act as an employer and otherwise successfully participate in a self-directed employer and/or budget authority service model.
• Communicates with Participant or authorized representative about additional supports or accommodations necessary for successful program participation.
• Performs in-home visits of Individuals as applicable by program.
• Documents and reports evidence of individual’s inability to self-direct appropriately.

Participant Education & Training

• Educates the individual/employer on interacting with Public Partnerships as their fiscal intermediary, with emphasis on their authorized services, timesheet completion, enrolling subsequent providers and keys to successful self-direction.
• Provides person-centered, need-based program education and guidance to Participants and authorized representatives specific to individual choices, goals and desired outcomes.
• Explains and educates on Participant/authorized representative and provider roles and responsibilities for participation in self-directed services, including processing payroll, vendor payments, tax withholding and reporting.
• Provides direct, including train-the-trainer, instruction on how to navigate program rules, expectations and Financial Management Systems, including online enrollment, service time capture, portal and emerging technologies.

Compliance, Risk Management & Safeguarding

• Provides train-the-trainer instruction on identification and reporting of suspected fraud, abuse, neglect and exploitation.
• Identifies, reports and appropriately follows up on allegations or reports of suspected fraud.
• Assesses for participant abuse, neglect, and exploitation, following the appropriate reporting protocol where necessary.

Documentation & Operational Excellence

• Maintains documentation of services provided and time committed in accordance with applicable policies and procedures.

Required Skills:

• Strong customer service and support experience
•  Proficient in Microsoft Office Suite, CRM, Nexus, Better Online, Adobe Sign platforms and web-based applications
•  High aptitude for process assessment, improvement, and recommendations
•  Exceptional verbal and written communication skills
•  Ability to develop strong working relationships with external and internal stakeholders

Qualifications:

Education: Related bachelor’s degree Preferred; can be substituted with 1+ years of related experience. Additional education and experience requirements as indicated by state contract requirements.

Experience: Minimum of one (1) year of experience serving individuals with disabilities and/ or aging adults preferred.

Working Conditions:

• Remote with regular business travel
• Must reside in the state of VA.

Compensation Range: $21.00 - $24.00 an hour

This role is eligible for a base salary within the posted range. Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location. Compensation may vary for positions based in high cost-of-labor markets.

The above is intended to describe the general contents and requirements of work being performed by people assigned to this classification. It is not intended to be construed as an exhaustive statement of all duties, responsibilities, or skills of personnel so classified 

Public Partnerships is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PPL will not tolerate discrimination or harassment based on any of these characteristics.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!