Adult Care Management Quality Assurance Assistant

Mission Statement: “To empower and inspire people of all communities to identify, pursue and sustain healthy, meaningful lives”.

MHAW strives to develop an authentic, diverse workforce that embraces, creates, respects and demonstrates diversity, equity, and inclusiveness in the work environment, towards one another and those we serve. We recognize that our agency is strongest when we all embrace the full spectrum of diversity and experience. We actively seek to employ a diverse workforce representative of the communities we serve.

MHAW is a pro-vaccination agency, and has required all staff to be fully vaccinated and encourages service recipients to be vaccinated against Covid-19.

Position: Adult Care Management Quality Assurance Assistant
Compensation: $50,000.00 per year
Location: Office-based positon, Ronkonkoma, NY
Hours: Full time, 37.5 hours per week (non-exempt)
Start Date: Immediately

Key responsibilities will include but are not limited to:

• Interfaces regularly with Care Managers, Care Management Leadership Team, Billing Revenue Management Supervisor and Database Administrator.
• Maintains working knowledge of DOH/Health Home Policies and Procedures and participates in Health Home facilitated meetings and webinars as requested.
• Demonstrates computer proficiency and good understanding of EHR – Cerner Millennium and Health Home IT platform – Foothold Care Management (FCM). Reviews and enters BSQ assessments in FCM.
• Utilizes PSYCKES (Psychiatric Services and Clinical Knowledge Enhancement System), a NYS web-based application, to review eligibility and identify qualifying factors that impact completion of monthly billing questionnaires.
• Runs PSYCKES report, using various criteria/filters and merges with CICBH Client Assignment Report to determine those on roster who may be eligible for HH Plus.
• Enters and utilizes billing authorizations with begin/end dates in EHR to track BSQ functional categories (i.e. homelessness, incarceration, inpatient hospitalization, SUD, etc.).
• Runs reports, utilizing EHR and HH platform, and distributes to Care Management leadership team to ensure that BSQ functional categories are addressed as required.
• Generates other reports as requested for purposes of Q&A, distribution, tracking and audits. Completes other data entry tasks as requested (in EHR and IT platforms).
• Performs audits to ensure that service delivery requirements are met for Health Home Plus program as well as those in other special populations (i.e. AOT, State Aid).
• Tracks and monitors start/end dates for Health Home Plus clients and communicates to Care Management leadership team.
• Has a keen eye for problem patterns, notes observations and communicates to Assistant Program Director and/or Program Director and Billing Revenue Management Supervisor in a timely fashion.
• Assists with quality improvement projects and contributes to the continuous improvement process, development of new procedures, workflows and forms.
• Ensures that all client records are updated, accurate and complete and assists in audit processes (internal and HH) when requested.
• Runs, analyzes and distributes reports from FCM to support timely completion of HH Comprehensive Assessments, HH Care Plans, Consents, etc. via the Leadership Monthly Tracking Report (LMTR).
• Generate and distribute Low Acuity Report and Exceptions Report according to schedule.
• Monitor client Medicaid inactivity and track those with R69/H1/H9 status.
• Utilize Unbilled Claims Report to complete monthly review and work with leadership team to address necessary corrections within established time frames.


The successful candidate should possess or be quickly able to acquire the following skills and abilities:

• Bachelor’s Degree in Business, Health Administration or Human Services field is preferred.
• Care Management experience preferred.
• Detail-oriented, reliable self-starter with the ability to work both independently and as part of a team.
• High degree of proficiency in navigating multiple computer platforms.
• Candidate must be fully COVID-19 vaccinated.

Self-Insurance- What are the REAL risks?

With the cost of health insurance continuing to skyrocket, non-profit employers are searching for answers when it comes to providing benefits to their employees. More organizations than ever before are turning to self-insurance in attempt to gain more transparency, drive down costs, and offer more attractive benefits to their employees. For non-profits with over 100 employees in NY, and even smaller  in other states this may be the solution.  So why is there still some resistance?  Risk is always a concern especially for non-profit organizations.  Factoring the high cost of healthcare especially in metropolitan markets, self-insurance can be scary words.  However, this begs the question, are they really getting a true depiction of what their risks are?  Probably not.  We find that most organizations do not have good understanding of what self-funding means and fear of the unknown always creates anxiety.  In addition, Boards may be resistant to anything that smells like fiduciary liability.   Insurance carriers that market fully insured plans and large brokers have profitable stakes in those plans so there may not be enough motivation to educate non-profits of what risks really exist.  Of course, self-funding is not for every organization, but in an environment where benefits are paramount to recruiting and retention, employers should be exploring all options to reduce cost and increase benefits including alternative funding options like self-insurance.

The real question is, what’s riskier, a fully insured contract through an insurance carrier which almost certainly guarantees renewal increases year over year, or a long term self-funded strategy focused on reducing healthcare costs?   With fully insured plans you are offered rates upon renewal based on your previous claims experience.  Those rates are locked in for a year in most cases, however if claims improve you cannot recoup those funds.  When employers pay their own claims, they save hard dollars in real time if claims improve.  This motivates them to take cost reduction, and wellness initiatives.  Self -funded plans put the employer in control of their healthcare and pharmacy spend allowing them to make financial decisions based on more accurate data that comes in real time which does not exist with fully insured plans.  Most often we hear that non-profit employers are concerned a major claim could wipe them out.  However, a properly designed self- funded strategy with appropriate stoploss contracts can eliminate those financial risks making it easier to forecast costs into the future.   Recently direct hospital relationships with large healthcare systems like Northwell Health have created opportunities for employers to offer incentives to employees who access care within the system.  With deeper discounts embedded within the direct relationships, employers can realize significant cost savings within their self-funded plans. 

Non-Profit employers should not dispel self-funded plans without a full exploration of their benefits and risks.  Brokers who work with experienced Third-Party Administrators can easily provide proposals which will clearly outline what their maximum liability would be.  Employers that qualify should consider getting customized proposals to help them better understand how self-funding works before determining whether it is too risky for them.  With the rise in healthcare costs not slowing down, what do they have to lose?

How to Leverage AI & Automation Tools to Elevate Your Nonprofit in 2023

By Alex Gambino / January 23, 2023

If you own a nonprofit, your main goal is to bring awareness to your cause and raise as much money as possible. Whether you have a nonprofit in healthcare, education, or anything else, everything you do is for the greater good. While you plan for big events, auctions, and partnership meetings; you may find it challenging to stay on top of your marketing initiatives and donor communication.

Thankfully, with the recent developments in artificial intelligence and automation tools, you no longer need to spend countless hours sending emails, creating content, or writing press releases.

You may be wondering: What exactly is artificial intelligence? Can my nonprofit actually benefit from these tools? We’re here to walk you through everything you need to know about how nonprofits can use these tools to improve workplace productivity.

Let’s take a closer look:

What exactly is artificial intelligence?

Artificial intelligence is commonly referred to as AI. To put it simply, it’s a computer system with human intelligence. These tools have the power to help with simple marketing tasks like collecting data, writing content, and brainstorming new ideas for your content marketing strategy.

Keep in mind, artificial intelligence can’t replace your marketing team. Instead, it helps your team restructure their work week, so they can focus on big projects, event planning, donor gifting, and the overall strategy you have in place. With the right tools, you can increase productivity and get time back in your day to focus on the bigger picture.

What are Automation Tools?

Automation tools help you automate mundane workweek tasks. With these tools, you can easily create email customer journeys that work in the background, publish social media posts, and stay on top of communication with partnerships or big donors.

Automation tools aim to simplify your workweek and give you time to focus on brainstorming new ideas and fine-tuning your strategic approach. Whether it’s email marketing, social media, or donor communication: With the right tools, your team will have what they need to automate mundane everyday tasks and test new ideas while eliminating the risk of human error.

How Nonprofits can benefit from AI and Automation Tools

While AI and automation tools are a relatively new concept, they have grown to be invaluable tools nonprofits in all industries can utilize to improve workplace productivity and streamline success. With the right tools, your nonprofit can get valuable time back in your day to focus on raising funds for your cause and creating connections with potential donors.

Here are three benefits:

Improve your donor outreach

With the right tools, you can easily create, send, and design template letters for donation outreach for event honorees. You can also stay connected with your customers and automate your communication to keep donors, sponsors, and partners in the know. This will help you stay ahead of donor churn and keep individuals focused on building relationships with donors.

Enhance your content strategy

Spending countless hours strategizing, writing, and creating next-level copy can be challenging, especially when you have other tasks that require more time. With AI and automation, you can generate auction item descriptions, write website copy, or create email content. This will give you time back in your day to focus on more important tasks.

Advanced segmentation and personalization

Personalization is a must-have in today’s digital age. It ensures your donors or partners feel recognized and heard by your nonprofit. However, personalizing and segmenting every email you send can be difficult without the right tools. With AI and automation, you can segment every email you send, personalize them, and automate your strategy. This will ensure all of your marketing has a personalized touch.

That’s only to skim the surface of the benefits of AI and automation. Once you’re ready to restructure your workweek with the power of AI, you’ll find that there are countless use cases for these tools.

Three ways to use AI and Automation for Nonprofits

1. Social media creative content & automation

Coming to the table with new and innovative content ideas can be challenging. Especially if you don’t have the time to put towards crafting a social media strategy. With the help of fully-automated social media tools like PostPanda, you can get creative content that automatically gets shared on your social networks.

The platform will create posts and captions you can use for Facebook, Instagram, LinkedIn, and more. This eliminates the need to constantly create social media content or templates. It’s like having your very own social media manager at your fingertips.

There are also DIY social media automation tools that allow you to post, schedule, and plan your content. These tools help you schedule content for the upcoming months so your team can focus on strategy. Most automation tools like Hootsuite also have a suite of reporting tools that can help you make informed, data-driven decisions about your content strategy.

2. AI copywriting

Wish there was an easier way to create compelling website copy? Well, with the help of AI copywriting, you can do all this and more. These tools help you rethink your content strategy and find new ways to connect with your audience. It makes writing compelling content in seconds.

With platforms like Jasper and ChatGPT, you can produce high-quality content that helps you connect with donors, volunteers, and prospective partners. You can develop template letters for donation outreach for event honorees, write a blog about a recent event, and create high-quality email content for newsletters.

Keep in mind: Your team will still want to read through and edit the content to add a human touch to your copy. This way, you can ensure your content aims to connect with your target audience and aligns with your overall goals.

3. Email marketing software

Email marketing is a must-have for any nonprofit. Not only is email marketing one of the most effective marketing channels you can capitalize on, but it is also the perfect channel for keeping your partners, donors, and sponsors informed about upcoming events, news, and insights into your nonprofit. However, sending emails out individually with a personalized touch can be a daunting task, especially if you have a big subscriber list.

With email marketing automation tools, you can easily create, send, and schedule emails. With tools like EmailOctopus, you can automate your email outreach, create captivating email designs, and take a segmented approach to your email marketing strategy. These tools also give you access to a suite of data and insights you can use to fine-tune your email marketing strategy and find new opportunities.

Partnering with an automation/marketing professional

In today’s digital age, it pays to have a partner that knows how to capitalize on automation and artificial intelligence. With a marketing professional, you can discover new tools and get time back in your day to focus on what’s most important: raising money for your cause. 

At Powered by Professionals, we help nonprofits fundraise for their cause and find tools that get them closer to success. If you’re ready to focus on raising money for your cause, take a strategic approach to donor communication, and get more from your campaigns: We’re here to help. Feel free to explore our solutions for your non-profit.

Contact us today to learn more.

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