Yaritza Hernandez

Central Support Care Coordinator – Central Operations – 01/2022 – PRESENT

Community Care - Manhattan NY

Referral assignment

High-Medium-Low (HML) assessment

Telephonic outreach

Assignment of providers to care team

Health and Recovery Plan (HARP)code reconciliation

Document uploads

Member mailings

Scheduling intake appointments for patients interested in services and assigning these intake appointments to
Directors of Care Coordination for assignment to Care Coordinators.

Documenting all notes of all outreach encounters in Epic EMR.

Closure of referrals/outreach episodes if member declines services or is unable to be located.

Reviews the Health Home Operations Report of members missing a Primary Care Provider (PCP) in the Care
Team and adds the missing provider to the care team in the Epic EMR.

Reviews the monthly HARP report of discrepancies between the HARP code in the billing portal and Epic EMR.

Complete corrections to the Health Home Episode in the EMR as needed; ensures that member records are also
reviewed in the Medicaid eligibility portal (EPACE) prior to completing corrections in the Epic EMR.

Uploads documents into member records in the Epic EMR as requested.

Referral Specialist - 06/2021 - 01/2022

Community Care - Manhattan NY

Monitored the Health Home referral phone line and email inbox on a daily basis for any incoming patient referrals and transmit them out to either the internal Care Manage Agency (CMA)'s outreach supervisors or one of the external CMAs for outreach and enrollment.

Utilized patient “chase list” to create outreach segments for all new high-risk, Health and Recovery Plan (HARP) and inpatient behavioral health patients.

Entered data for new patient referrals who are not already in the electronic medical record (EMR) with all demographic and contact information from the incoming patient referral.

Poroficient with the Electronic Provider Assisted Claim Entry System (ePACES) and the Medicaid Analytics Performance Portal (MAPP) in order to review patients' Medicaid and Health Home status, for the purpose of determining patients' eligibility for the Health Home program.

Completed the following for each patient referral in the EMR: a) assignment of “Primary CMA” to reflect the name of the CMA that the patient referral was directed to b) start date of referral segment; c) upload referral document and; d) enter progress note stating referral assignment information, including name of referral source.

Responsible to keep up-to-date Medicaid's guide to restriction exception (RE) codes in relation to Health Home services in order to ensure that patient referrals to the program are qualified in accordance with such Medicaid's guidelines.

Covid 19 Central Processing Unit / 02/2020 - 06/2021

Community Care - Manhattan NY

Create patient a new medical account on Epic and update information.

Create a pending admission for patient.

Arrange Transportation for patient from Hospital to Hotel or from Patient location.

Track and confirm patient arrival to hotel.

Enter patient referral into Patient Tracker.

Call patient to educate on hotel program stay and answer patient question and concerns.

Contact Hospital social worker for patient discharge.

Answer calls from call center line to receive phone referrals and questions about covid 19 program.

Making sure patient has a safe and secure transportation and transition to Hotel.