ASD Benefit Support Specialist

Under the general supervision of the ASD Benefits Program Administrator, the ASD Benefit Support Specialist is responsible for monitoring member information and data integrity in the Mental Health Wellness Information Network (MHWIN) system. This individual is also responsible for supporting the Autism Service Team to ensure Medicaid Behavioral Health Treatment (BHT) requirements are met.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Connects stakeholders to ensure eligible beneficiaries are enrolled and engaged in behavioral health services.
• Assists in the referral, enrollment, transfer, and disenrollment in Autism Services.
• Supports the Autism Service Team to ensure Medicaid Behavioral Health Treatment (BHT) requirements are met.
• Assists in monitoring the group email for coordination of care to service providers and documentation review for qualifying screening and diagnosis.
• Coordinates with the DWIHN Access Call Center on screening, diagnosis, eligibility, and referral to necessary service providers.
• Prepares autism related reports and statistics as needed by DWIHN to monitor service quality and service delivery trends.
• Retrieves caseload data and monitors data integrity for NCQA.
• Provides support to ensure data integrity of beneficiary information in the MHWIN Member Charting System.
• Completes monthly enrollment review to correct discrepancies and ensure data integrity.
• Completes monthly document compliance reports and compiles notice as needed for providers.
• Completes discharge procedures to ensure members receive notification and previous provider early termination authorizations.
• Uploads necessary transition and discharge documentation.
• Monitors case status and provides technical support to providers as needed to ensure efficiency and quality.
• Works closely with the ASD Program Administrator to ensure case coordination of beneficiaries for Autism Services.
• Update service providers of poor coordination of enrollment to ensure service integrity is maintained.
• Reviews and corrects cases that are missing data in MHWIN or that are outside of Performance Indicators.
• Coordinates with the Clinically Responsible Support Providers (CRSP) and ABA Providers on cases, focusing on case outliers to ensure timely access and coordination of care.

• Retrieves MHWIN Scanned Document Performance Indicator Reports and compiles notice templates.
• Assists in facilitating monthly provider network meetings including collecting attendance, creating content for PowerPoint slides and finalizing Q & A content.
• Assist in scheduling clinical behaviorists for presentations for training and technical assistance.
• Attends autism resource events to distribute and answer questions related to accessing Autism Services.
• Creates reports and updates as needed.
• Provides on-going case monitoring and follow-up.
• Assists in monitoring network autism usage and tracks trends.
• Performs related duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES (KSA'S)

• Knowledge of DWIHN policies, procedures and practices.
• Knowledge of the DWIHN provider network and community resources.
• Knowledge of the Michigan Mental Health Code.
• Knowledge of MDHHS policies, rules, regulations and procedures.
• Knowledge of Federal policies, rules, regulations and procedures as it relates to DWIHN.
• Knowledge of behavioral health and mental health principles and practices.
• Knowledge of the Michigan Medicaid Provider Manual.
• Knowledge of MHWIN.
• Knowledge of the Medicaid Autism State Plan.
• Knowledge of the field of mental health with a specialty in the field of Autism.

• Organizational skills.

• Time management skills

• Planning skills.
• Accuracy skills.
• Coordination skills.
• Computer skills (Word, Excel, Access, Power Point, Outlook, Teams).
• Ability to self-initiate.
• Ability to communicate orally.
• Ability to communicate in writing.
• Ability to work effectively with others.
• Ability to work with an ethnically, linguistically, culturally, economically and socially diverse population.
• Judgement/Reasoning ability.

REQUIRED EDUCATION:

A Bachelor's Degree in Mental health, the Human service, the Social service or a related field.

REQUIRED EXPERIENCE:

Two (2) years of full-time paid experience in the field of mental health, human services, or social services.

Knowledge of Medicaid Autism Services and experience with applied behavior analysis (ABA) is preferred.

REQUIRED LICENSE(S).

A valid State of Michigan Driver's License with a safe and acceptable driving record.

WORKING CONDITIONS:

Work is usually performed in an office setting but requires the employee to drive to different sites throughout Wayne County and the State of Michigan. This position can work remotely with supervisory approval. Currently this position is primarily a remote position.

This description is not intended to be a complete statement of job content, rather to act as a general description of the essential functions performed. Management retains the discretion to add or change the position at any time.

Please Note: DWIHN requires proof of being fully vaccinated for COVID-19 as a condition of employment. Medical or religious accommodations or other exemptions that may be required by law, will be approved when properly supported. Further information will be provided during the recruitment process.

The Detroit Wayne Integrated Health Network is an Equal Opportunity Employer