JOB ANNOUNCEMENT

TITLE: PRC/CHS ASSISTANT

EMPLOYER: ROCKY BOY HEALTH BOARD

SUPERVISOR: PRC/CHS SPECIALIST

SALARY: NEGOTIABLE DEPENDING UPON EXPERIENCE

STATUS: REGULAR FULL- TIME

OPENING DATE: SEPTEMBER 21, 2016

CLOSING DATE: OCTOBER 5, 2016 – 4:30 P.M.

PROBATIONARY

PERIOD: SIXTY (60) CALENDAR DAYS FROM INITIAL APPOINTMENT

MAJOR DUTIES:

· Assists in determining patient eligibility, scope, and priority for the PRC (Purchased Referred Care)/CHS (Contract Health Services) Program.

· Responds to PRC/CHS inquiries and requests for PRC/CHS assistance.

· Responsible for implementation of decision made for the provision or denial of services.

· Assures adequate funds are set aside for all authorized referrals, emergency call-ins and follow-up care referrals.

· Maintains the Service Unit Commitment Register for PRC/CHS funds.

· Compiles reports of statistical and fiscal date.

· Responsible for PRC/CHS Fund Control, updates pending and completed PRC/CHS patient files, with documented status of all written and verbal transactions.

· Responsible for key entering and verifying all PRC/CHS authorizations, payments, cancellations, and supplements.

· Initiates medical authorization to include hospitalization and medical fees for eligible Native Americans.

· Authorization documents are reviewed for patient information, clinical data, obligation signatures, certification signatures and fiscal data.

· Monitors activities and records pertaining to the fiscal management of PRC/CHS. Identifies problem areas and recommends corrective action.

· Advises PRC/CHS Specialist of any unusual costs regarding contract health services.

· Independently contacts state agencies to determine medical eligibility within the jurisdiction of the Tribal Health Facility/ cross checks proposed authorizations against sources prior to obligating the Tribal Health for PRC/CHS.

· Provides information as well as Tribal Health Facility personnel to ensure that there is a thorough understanding of the program policies and procedures.

· Verifies census records for applicants to contract care funds by addressing inquiries to a variety of identified sources.

· Other duties as assigned per supervisor, CFO, CEO

MINIMUM QUALIFICATIONS

· One (1) year of specialized experience to perform successfully the duties of the position or 4 years of education above high school.

· Applicants, who have the 1 year of appropriate specialized experience, as indicated, are not required by this standard to have general experience, education above the high school level, or any additional specialized experience to the meet the minimum qualification requirements.

· Knowledge of eligibility requirements, regulations, and statistical, fiscal, and ICD-9/10-CM coding procedures for PRC/CHS.

· Knowledge of medical terminology to identify need for information and/or communicate with health providers.

· Third party liability and payments.

· Skill in communicating both orally and in writing.

· Skill in interviewing patients to obtain necessary information.

Desired Qualifications:

Associate Degree in Public Health Administration or related field or five (5) years specialized experience for the duties of the position.

Other Selection Criteria:

· Qualified Chippewa Cree members who are honorably discharged veterans will be given preference. DD214 required.

· Chippewa Cree Tribal Preference.

· Will be subject to random drug testing.

· If terminated from any position within the Chippewa Cree Tribe for violations of the Drug Ordinance I-99 applicant must have completed the requirements and submit the documentation from CDC that applicant has completed requirements.

· Only those applications properly completed and received on or before the closing date will be considered for the position advertised.

· Applicants who meet the required qualifications described above will be further evaluated to determine the extent to which their education, work related experience, training awards, professional recognition and supervisory appraisals indicate they possess or have the potential to acquire knowledge, skills, and abilities (KSA’s) required to perform the duties and responsibilities described above.

· On a separate sheet of paper discuss how you performed or have potential to develop the particular knowledge, skill or ability listed below. Failure to submit written responses as part of your application may result in an ineligible rating or substantially lower score.

Knowledge, Skills and Abilities (KSA’s):

1. Knowledge of ICD-9/10-CM coding. [show examples, previous jobs, education on KSA’s]

2. Knowledge of alternative resources (etc. third party, Medicare/Medicaid) [show examples, previous jobs, education on KSA’s]

3. Knowledge of PRC/CHS rules and regulations [show examples, previous jobs, education on KSA’s]

4. Knowledge of Indian descendancy and residency as it relates to PRC/CHS eligibility criteria [show examples, previous jobs, education on KSA’s]

5. Knowledge of Medical Terminology [show examples, previous jobs, education on KSA’s]

Candidates must submit the listed items:

· Letter of interest/Cover letter

· Diploma or Transcripts, showing degree (OFFICIAL)

· Resume and application

· Three (3) current letters of Reference (within 1 year)

· Proof of Tribal Enrollment, if applicable

· Possess valid current Montana Driver’s License

· Proof of Veteran- Honorable Discharge, if applicable

· Proof of completion of follow up of termination for I-99 Drug Ordinance

· Knowledge, Skills, and Abilities (KSA’s)

Submit to: Geri Racine, Human Resources Offr and/or Taunia Racine, Human Resources Associate

Rocky Boy Health Board

R.R.1 Box 664

Box Elder, MT 59521

Telephone (406) 395-44860- xc

____________________________________________ ________________________

Jessica Windy Boy, CEO Date