Description & Requirements
About the Children and Youth Evaluation Services (C-YES) Program
Maximus has partnered with the New York State Department of Health to establish the Children and Youth Evaluation Service (CYES) program to determine whether a child or youth is eligible for home and community-based services (HCBS) covered by Medicaid. CYES makes eligibility determinations primarily for children and youth aged 0-21 years who have been identified as being Medically Fragile (MDF) or having a Serious Emotional Disturbance (SED). CYES Nurse Evaluators conduct conflict-free evaluations of these children and youth to assess their needs for HCBS and develop person-centered plans of care. CYES Family Support Coordinators provide coordination and referral services and assist HCBS-eligible children or youth to apply for Medicaid.
Essential Duties and Responsibilities:
- Ensure individual and service level standards are met or exceeded, and staff members are appropriately trained.
- Responsible for ensuring processes are working to support customer needs.
- Ensure the overall volume of work produced meets or exceeds quality standards.
- Ensure staff maintains an updated knowledge of all programs.
- Ensure the confidentiality and security of all information.
- Monitor the performance of staff and provide feedback and education to improve performance.
- Provide management with updates on all issues regarding quality, training, policy, procedures, and staff issues.
-Addresses and resolves escalated or complex case issues.
-Perform as acting Supervisor in the Supervisor’s absence.
-Conducts outreach to obtain pertinent consumer information and identify parties to receive notification of impending assessment appointment
-Conducts timely outreach and meets productivity targets related to scheduling assessment appointments with all appropriate individuals identified and documents all outreach activities for tracking and reporting purposes
-Ensures consumer needs are met when scheduling assessment appointments and the most appropriate resource is assigned to complete the assessment.
-Ensures the scheduling process and workflow runs efficiently and meets all program objectives and quickly identifies areas for improvement or correction.
-Assists in scheduling appointments with a RN and participates in the appointment when possible
-Responds to inquiries from all stakeholders and provides education about the CYES program and associated program/services
-Provides case management services to support the plan of care
-Identifies appropriate referrals and community resources to support the plan of care
-Provides follow up to ensure consumers access community providers and resources included on the plan of care
-Reviews and acts on reports with FSC staff, as assigned by the FSC Supervisor and Operations Support Manager.
-Assist with the monitoring of CYES Helpline and escalates issues as needed to Supervisor and Operations Support Manager.
-Assist Supervisor with identifying outstanding follow ups with different stakeholders
-Assists with training and policy updates where assigned.
-Performs other duties as may be assigned by Management
- High school diploma or GED required and 6+ years of relevant professional experience required, or equivalent combination of education and experience.
-Minimum of three (3) years of experience working with individuals with mental, behavioral, developmental, and physical health issues disabilities in a case management capacity
-Experience utilizing reports and data to support a program
-Computer literacy; strong knowledge of MS Excel
-Ability to learn new software programs quickly and intuitively.
-Excellent organizational, interpersonal, written, and verbal communication skills
-Ability to perform comfortably in a fast-paced, deadline-oriented work environment.
-Ability to successfully execute many complex tasks simultaneously.
-Ability to work as a team member, as well as independently.
Preferred Qualifications:
-Working experience with pediatric, psychiatric and/or medically fragile patients
-Working knowledge of Health Homes, the Children's Waiver, and/or Home & Community Based Services
-Experience working with call center systems
Home Office Requirements:
-Reliable high-speed internet service
-Minimum 5 Mpbs upload speeds