SUMMARY: This position is responsible for serving as the subject matter expert of medical policy for both Virginia Department of Social Services (VDSS) and Office of Refugee Resettlement (ORR) for unaccompanied children. They will work with Point of Comfort Underwriter Insurance, ensuring effective operations at the respective regional site location, developing positive working relationships with contracted providers within the respective medical program(s). This individual is also responsible for reconciling and addressing all billing errors to ensure accurate billing with no profit loss.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ensure effective operations through selection, training, motivation, evaluation and development of a competent on-site Medical Coordination team as a team lead.
• Formulate treatment authorization request to Point Comfort Underwriters for unaccompanied refugee clients, as needed.
• Serve as the subject matter expert of Point Comfort Underwriters Insurance.
• Develop, recruit, and maintain positive working relationships between contracted providers to include all health providers and related partners.
• Manage and maintain the record-keeping process to ensure there is an effective filing system in which information is forwarded smoothly.
• Ensure documentation and filing compliance with all required forms in accordance with the agency, state licensing, and ORR.
• Effectively train branch locations on documentation compliance in accordance with agency, state licensing expectations, and ORR, as needed.
• Reconcile and address all billing errors to ensure accurate billing with no profit loss.
• Maintain accurate, up-to-date information on foster children residing in shelter while meeting DHS, ORR, and agency documentation and reporting requirements.
• Stay abreast of all agency, federal, and state regulatory requirements related to social services.
• Periodically travel to health care provider facilities to build positive working relationships and transport clients.
• Represents the Agency in the community and workplace in a professional and ethical manner.
• Demonstrates sensitivity to the service population’s cultural and socioeconomic characteristics.
• Demonstrates strong interpersonal, decision-making, problem-solving, oral, and written skills.
• Utilizes a basic knowledge of Microsoft Office applications.

EDUCATION and/or EXPERIENCE:

• A master's degree in medical field, social work, psychology, or counseling.
• A baccalaureate degree in medical field, social work or psychology with documented field work experience and must be supervised by the program director or other staff employed by the provider with the same qualifications.
• A baccalaureate degree and three years of professional experience working with children.
• Must be bilingual in Spanish and English.