CMA Coordinator PAR

Join a Winning Team at One of Colorados Best Workplaces!

The Resource Exchange (TRE)
At TRE we dont just provide services we transform lives. Our commitment to empowering individuals and creating inclusive communities has earned us recognition as one of Colorados top employers for five consecutive years. But dont just take our word for it:
The standard of work and the culture of providing excellent service is something Im proud to be a part of. Current TRE Staff Member November 2024

Why TRE is the Place for You:
Make an Impact: Advocate for and empower people of all ages and abilities from infants to seniors creating lasting change through collaboration with families communities and partners.
Work with Purpose: As part of a dedicated team youll help strengthen families and promote inclusion in communities across El Paso Pueblo Teller and Park counties.
Enjoy a Positive Work Environment: Join a culture thats consistently recognized as one of the Best Workplaces in Colorado.
Who We Are:
At The Resource Exchange we pride ourselves on being a team of over 400 passionate and talented staff who serve more than 12000 individuals. From those with disabilities and mental health challenges to those in need of longterm care we provide personcentered support focused on independence inclusion and collaboration.
What We Offer:
Comprehensive Benefits: Health dental vision Lifestyle Spending Account for health and wellness plus pet insurance for your furry friends
True Flexibility: Flexible work schedules to fit your life (yes we really mean it!).
HalfDay Fridays: Start your weekends early every week!
Generous Time Off: Paid Time Off with your birthday off paid holidays and time to celebrate what matters most to you.
Public Student Loan Forgiveness: Were invested in your future.
Volunteer Opportunities: Paid time off to give back to the community.
Growth & Development: Leadership career advancement and workgroup opportunities to help you thrive.
Come thrive with us! At TRE your passion for service will be recognized and youll be part of a culture that celebrates making a difference.
Ready to join one of Colorados Best Workplaces Apply today

THE RESOURCE EXCHANGE

Job Description

The Resource Exchange

Position Title: CMA CoordinatorPrior Authorization Request (PAR) (NQ)

Department: Case Management

Reports to: Program Supervisor

FLSA: Nonexempt

Supervisor responsibilities: N/A

Starting Range: $21.78 $22.62 hourly * rates reflect FY2425 and subject to change contact to confirm rates.

Benefits offered: Health dental vision employer paid life and shortterm disability voluntary life voluntary longterm disability 401K with employer contributions pet insurance other supplemental insurance options flexible work environment training and growth opportunities workgroup participation public student loan forgiveness mileage reimbursement and more.

General Description:

The Prior Authorization Request (PAR) Coordinators complete a thorough review of documentation and state databases to ensure Prior Authorization Requests (PARs) are in compliance with Rules and Regulations set forth by Health Care Policy and Financing (HCPF). They complete revisions utilization enrollments and continued stay reviews in a timely manner and provide feedback when plans need additional information or documentation. They also partner with Provider Approved Service Agencies (PASA) Service Coordinators and HCPF to complete PARs through a various means of communication. They also keep detailed information and track the progress of each PAR created revised and submitted

Essential Duties/Responsibilities:

1. Promote excellent internal and external customer service through written and verbal communication to all TRE stakeholders with the intent of promoting TREs values through intentional communication strategies daily.
2. Exhibit strong written and interpersonal communication skills to promote clarity of intent with all levels of communication daily.
3. Develop a strong understanding of the rules and regulations that direct LTC and IHSS services to maintain compliance and best support the people served by TRE daily.
4. Critically analyze case documentation behavioral and medical reports guardianship paperwork financial documents and other data pertaining to promote the health and wellbeing of the people we serve daily.
5. Enter case notes in multiple systems to promote documentation of all client contact communication records and tasks completed for the people we serve daily.
6. Organize and implement service plan development tasks (varies by position) in person by phone and/or through the use of technology (i.e. Outlook Office 365 ZOOM etc.) to promote and remain knowledgeable of the needs of the people we serve while maintaining compliance with rules regulations policies and procedures daily.
7. Develop positive relationships with all TRE stakeholders to promote TRE mission vision and values through all interactions daily.
8. Maintain client and company records utilizing a variety of internal and external data management systems to support continuity of care manage client contacts support transparency comply with HIPAA standards and promote state and federal regulations daily.
9. Cultivate an understanding of community resources in addition to those provided by TRE to support the additional needs of the people we serve weekly.
10. Maintain HIPAA standards throughout all aspects of TRE engagement to comply with regulations and protect the privacy of the people we serve and TRE staff daily.
11. Attend departmental and agency meetings and trainings in person by phone and/or through the use of technology (i.e. Outlook Office 365 ZOOM etc.) as specified by the meeting or training coordinator to maintain and improve your performance knowledge skills and abilities to best support the people served by TRE weekly.

Other Duties/Responsibilities:

1. Support team members through providing coverage of essential and other duties to maintain quality of and continuity of services for the people served by TRE monthly.
2. Participate in professional goal creation through the development and implementation of your career aspirations at TRE to further you performance knowledge understanding of the topics outlined in your career development plan quarterly.
3. Adapt to a changing work environment due to last minute changes in state and federal rules and regulations that effect TREs policies and procedures to best support the people served by TRE annually or as needed.
4. Assume other duties as assigned to promote the health and wellbeing of the people served by TRE and to promote the health and wellbeing of the organization annually or as needed.

Job Qualifications:

Knowledge Skills and Abilities:

1. Maintain a solid understanding of case management best practices.
2. Must have a friendly disposition and positive attitude.
3. Possess empathy for people with longterm care support needs.
4. Independently organize daily tasks and activities to ensure strict deadlines are met while prioritizing emergencies as they arise. Qualified coordinators have a strong skillset with organization.
5. Complete tasks using computerbased technology. It is a must that every coordinator possesses a strong understanding of how to accurately use and manipulate Apple iPhones desk phones Microsoft 365 (TEAMS Word Excel PowerPoint SharePoint OneDrive etc.) Outlook SKYPE for Business Adobe Acrobat and can use or learn to use additional plugins for these products. In addition to these technologies coordinators are expected to learn several state and proprietary data bases to maintain accurate records.
6. Use problem solving and critical thinking skills daily.
7. Must possess cultural awareness emotional intelligence and be aware of unconscious biases.

Education and Experience Requirements:

Minimum: Bachelors degree in a human behavioral science or related field of study. If an individual does not meet the educational requirement considerations may be made if the individual has experience working with longterm services and supports (LTSS) population in a private or public agency or has a combination of LTSS experience and education demonstrating a strong emphasis in a human behavioral science field.

Preferred: Working knowledge of Medicaid Waiver programs and requirements; experience working with persons with disabilities. Knowledge of and experience working with community resources and resource development.

Material and Equipment Directly Used:

Computers Printers Copy Machines Surface Pro/tablets Cell phones/telephone Cloud based systems and software etc.

Working Environment and Physical Activities Office community private residences commercial properties and virtual environment settings. Moderate physical activity required such as walking sitting standing and lifting up to 20 pounds. (Provides ADA accommodations at the request of the employee.) A working vehicle valid CO drivers license (unless active Military family) is required and auto insurance coverage with bodily injury and property damage liability coverage ($100000/$300000/$100000 coverage recommended) are required.

This job description is not intended to be an exhaustive list of all duties responsibilities or qualifications associated with this job. Therefore The Resource Exchange reserves the right to amend and/or modify this job description at any time. The Resource Exchange also reserves the right to stipulate hours of employment; work schedules may be changed to respond to business requirements.

The Resource Exchange is committed to affording an equal employment opportunity to qualified individuals regardless of their race color religion national origin sex sexual orientation gender expression gender identity age height weight disability status veteran status military obligations and marital status. We are also committed to conforming with the content and spirit of applicable Equal Opportunity and Affirmative Action laws and regulations. This policy applies to recruiting hiring training education promotion compensation benefits termination and all other privileges terms and conditions of employment.