POSITION: SMP Specialist -Medicare Fraud Prevention for Coos, Grafton, Carroll, Belknap (30-40hrs)

AGENCY: Partnership for Public Health (PPH)

REPORTS TO: Human Services Administrator

STATUS: Full-time Hybrid

The ADRC (Aging & Disability Resource Center) is a program of the NH Department of Health and Human Services. Through a contract Partnership for Public Health (PPH), ADRC helps individuals’ access and make connections to long term services and supports, access family caregiver information and supports, explore options, and understand and access Medicare and Medicaid. ServiceLink is designated as New Hampshire's Aging and Disability Resource Center and the NHCarePath Full-Service Access Partner providing services for individuals of all ages, income levels and abilities.

This position is within a public health organization that follows CDC guidelines and recommendations.

RESPONSIBILITIES: The SMP shall oversee the Senior Medicare Partrol (SMP) services for their respective region. The SMP Specialist is responsible for empowering and assisting Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education. In addition, the SMP Regional Coordinator will:

1. Develop and maintain an understanding of PPH and ADRC programs, services, and functions across all subject matter domains to facilitate efficient access to community services and supports;

2. Maintain up-to-date knowledge of the SMP project and all parts of Medicare including but not limited to: supplemental plans/Medigap insurance, prescription drug plans, Medicaid, Medicare Savings Programs, Social Security, etc in order to facilitate SMP program deliverables;

3. Provide one-to-one counseling to clients on issues related to SMP education, counseling, assistance, and outreach including how to protect personal health information, detecting payment errors, and report questionable Medicare billing situations;

4. Provides information, referrals, assistance, and follow up to clients through home and community visits, telephone, walk-in, group sessions, or email as needed/appropriate.

5. Increase community awareness and prevention of health care fraud and abuse through education, counseling, assistance, and outreach for the individuals with Medicare, with a specific emphasis on those isolated and with the greatest need.

6. Provide group outreach and education events, at a minimum, per scope of services with an emphasis on providing and distributing SMP outreach information in the respective geographic area.

7. Recruit, train, and maintain volunteers to assist with SMP program deliverables using the Volunteer Risk and Program Management (VPRM);

8. Assures all electronic client records are maintained accurately by following documentation policies and Inform USA standards;

9. Coordinate exchange of health insurance related information between Resource Center staff and volunteers, and state and federal agencies, including the NH Department of Health and

Human Services Bureau of Aging and Adult Services (BAAS), Office of the Inspector General (OIG), Centers for Medicare & Medicaid Services (CMS) and the Administration on Community Living (ACL);

10. Assist Human Services Asministrator in completing all required reports as well as coordinates record keeping and reporting for SMP programs as required by CMS, ACL, BEAS, and ADRC. This currently includes Navigate, SMP Information and Reporting System (SIRS), and the ADRC Outreach and Education Report.

11. Maintain adequate stocks of up-to-date print and video resources related to the SMP programs and other ADRC functions to support consumer access to community supports and services;

12. Assists the Human Services Administrator and coordinates with DHHS, BAAS SHIP/SMP Director and on statewide initiatives relative to SMP activities;

13. Attends staff meetings and trainings as required;

14. Performs other duties as assigned by the Human Services Administrator that will assist with Resource Center team functions to include serving on various committees, as requested.

15. Perform other duties as assigned by the Chief Executive Officer or the Chief Operating Officer of the Partnership for Public Health, Inc.

EDUCATION, EXPERIENCE, AND SKILLS REQUIRED:

1. Bachelor’s degree preferred or Associate’s degree with equivalent experience.

2. Obtain Senior Medicare Patrol Complex Interactions Training within 3 months of hire;

3. Obtain certification as Information Referral Specialist (InformUSA) and Person-Centered Options Counseling within one year of hire;

4. Experience in customer relations, call management, information and referral or related field that includes phone skills and preliminary assessment and triage ability of contacts;

5. Experience working with older adults, caregivers, veterans, and/or persons with disabilities, knowledgeable about local, state and national resources;

6. Working knowledge of human service delivery system;

7. Moderate skills in: listening, customer service, interviewing, and understanding of services, advocacy, and documentation;

8. Good interpersonal skills, openness and flexibility in working with diverse groups, and enthusiasm for working collaboratively with a team;

9. Good computer skills;

10. Ability to establish and maintain effective working relationships with groups such as: representatives of other social service agencies, institution officials, the public, and clients;

11. Ability to organize and present at educational and outreach events;

12. Ability to communicate effectively, one-on-one or in group situations, to explain complexities of Medicare, to summarize data, to prepare reports and to make recommendations based on findings which contribute to quality of SHIP and SMP programs, solving problems and meeting work objectives.

This position requires:

1. Minimal requirement to reach at or above shoulder level; occasional reaching below shoulder level required.

2. Ability to travel throughout the territory required.

3. Ability to work a flexible schedule, which may include night and weekends.

4. Ability to tolerate prolonged sitting and/or standing and to lift up to approximately 25 pounds to waist high level whenever necessary.

5. Mobility includes regular sitting, some standing and walking.

6. Maintain a valid driver’s license, good driving record and access to a fully insured car;

7. Criminal Records and Bureau of Elderly and Adult Services Registry record check and acceptance by agency

DISCLAIMER STATEMENT: The job description lists typical examples of work and is not intended to include every job duty and responsibility specific to a position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that position.

Pay: $22.00 - $24.00 per hour

Benefits:

• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

License/Certification:

• Driver's License (Required)

Ability to Relocate:

• Laconia, NH 03246: Relocate before starting work (Required)

Work Location: Hybrid remote in Laconia, NH 03246