General Dynamics Information Technology Medical Services Coordinator in Washington, District Of Columbia
The Medical Services Coordinator coordinates the administration of medical services program pursuant to policies and procedures and recognized clinical practice guidelines. Primary duties include oversight of medical services authorization requests from medical, dental, and mental health providers supporting a government agency program and provision of training and technical assistance to care provider grantees on aspects of the medical services program. These duties are carried out in consultation with the agency's medical team.
DUTIES AND RESPONSIBILITIES
Functions as the first level reviewer to determine medical necessity and appropriateness of requested services.
In collaboration with the Medical Team, assists in further development the medical services program, including but not limited to development of health-related policy and guidance on health issues.
Routine medical quality assurance reporting through frequent program monitoring and collaboration with the monitoring team.
Tracking and follow up of diseases of public health concern including contact with state health departments and ensuring continuity of care, and data collection.
Maintain and manage health surveillance data in multiple data systems including MS Excel, Access, and health surveillance system;
Provide technical and database administration support to federal staff.
Provides support to and acts as a liaison for medical cases requiring specialized care.
Liaises with external treatment authorization and billing contracting firm. Responds to requests for service authorization, first by establishing the eligibility of the potential recipient by using agency data systems and/or by directly contacting officials or grantees.
Submits ongoing activity reports which include significant accomplishments, issues, problems, special cases weekly review, and workload activity. Other activity reports or data for financial review or research purposes may be requested as necessary.
In conjunction with agency-funded care provider programs, troubleshoots issues related to reimbursement for medical services, provision of pharmacy benefits, and select specialized health care services, via direct interaction with Point Comfort Underwriters and the Veterans Administration's designated personnel ("the VA") and other health service officials.
In collaboration with the Medical Team, conducts training as necessary on basic medical or public health topics.
Works with field staff and headquarter staff to trouble shoot and resolve medically relevant issues with grantees.
Maintains up-to-date clinical knowledge of health issues affecting the unaccompanied children population and on an ongoing basis provides health-related information to agency-funded care provider programs and federal staff and managers.
Participates in regular staff meetings, disease case review, conferences, and events, as required.
Bachelor's Degree in a related technical discipline, or the equivalent combination of education, professional training, or work experience.
5-8 years of related experience.
Must have public health background and/or direct patient care experience.
Must possess demonstrated health care experience with adolescents and children. Experience working with youth in a residential setting is desirable. Experience in mental health services is desirable.
Must have previous experience in medical case management, utilization review, procedural coding or other applicable experience.
Must have the ability to analyze public health issues, manage issues with the timely and appropriate provision of medical services, and recommend timely and effective solutions.
Must have experience in using MS Office (Excel and Access)
Must be able to plan and organize her/his own workload.
Must have demonstrated experience in providing training or technical assistance on topics related to adolescent or children's health issues and medical care.
Must have demonstrated knowledge of international health issues. Demonstrated knowledge of health issues particular to Hispanic or Central American youth is desirable.
Must have excellent verbal and written communication skills.
For more than 50 years, General Dynamics Information Technology has served as a trusted provider of information technology, systems engineering, training and professional services to customers across federal, state, and local governments, and in the commercial sector. Over 40,000 GDIT professionals deliver enterprise solutions, manage mission-critical IT programs and provide mission support services worldwide. GDIT is an Equal Opportunity/Affirmative Action 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, or any other protected class.
Job FunctionProgram Management
Security Clearance LevelNone
Full/Part TimeFull Time