Why Work at First?
Excellent question! With over 800 locations across our divisions, you will have exponential growth opportunity. Furthermore, because safety is our number one priority, you will work in a safe and positive work environment every day. Lastly, you will receive a competitive benefits package that includes: 401k with company match, paid time off, and a complete insurance plan after 30 days of employment (health, dental, and vision).
What Does a Facility Outreach Manager Do?
The Facility Outreach Manager works closely with facilities and medical providers to improve Member experience and respond to service issues. In this role you will visit facilities regularly to provide information and training about NEMT and learn about facility needs and concerns. You will function as a liaison for Members and case-managers and will work to promote positive relationships within the healthcare community.
Responsibilities of a Facility Outreach Manager
- Travels to healthcare facilities to provide community-based outreach and education
- Provides training and education in person and via webinar to facilities on how to use NET services effectively
- Develops and maintain relationships with facilities through face- to- face meetings, phone calls and group presentations
- Promotes company initiatives with healthcare facilities and case workers
- Provides post-meeting follow up/communication to healthcare facilities and First Transit departments accordingly
- Works across departments to improve Member experience and address service issues
- Performs thorough reviews of non-emergency transportation claims and supporting documentation.
- Determines medical necessity for transportation level of service based on the documentation provided.
- Manages Grievance & Appeals process including identifying trends and developing actions plans to address deficiencies and reduce grievances
- Consults with medical facility staff to ensure that the most medically appropriate and cost-effective mode of transportation is requested
- Correctly interprets and apply all relevant and applicable requirements, guidelines, and standards.
- Investigates potential fraud, waste, and abuse by performing claim reviews and post-trip auditing.
- Assists with the development of tools, policies and procedures and educational materials.
- Analyze and trend data and assists with developing process improvements
- Works with Operations to ensure compliance with guidelines
- Assists with adjudication of denials and appeals and presenting cases effectively to Fair Hearing Officer during appeals proceedings
- Manages an effective team
- Performs additional duties as needed
What we would like you to possess:
- BA/BS or equivalent work experience
- Experience interacting with health plans and healthcare facilities strongly preferred
- 3 years relevant work experience strongly preferred
- A valid driver's license
- Strong verbal, written, interpersonal communication skills and ability to deliver clear, effective, and engaging oral presentations to a public audience
- High level of technical competence, including proficiency with Zoom and Microsoft Office Suite; advanced Excel skills a plus
- Solution-oriented and innovative thinking ability; must be able to develop and implement action plans to address service issues
- A proactive approach to relationship building and maintenance
- Ability to work independently and as a team member
- Strong time management and organization skills
Apply today to join our team
FirstGroup is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. FirstGroup is also committed to providing a drug-free workplace. For candidates applying to positions in San Francisco or Los Angeles California, FirstGroup will consider for employment qualified applicants with criminal histories consistent with the requirements of the San Francisco Fair Chance Ordinance or Los Angeles Fair Chance Ordinance.
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