The posting
Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs supported by a Nurse, and Case Manager, Vitra ensures clients receive compassionate, personalized, and dignified care.
The Care Access/Intake Manager leads the Care Access team and oversees the full intake process, from referral through enrollment, while ensuring that every client maintains continuous authorization for services. This role is critical to the organization’s growth and revenue, as it directly affects admissions, regulatory compliance, and continuity of care.
Key Responsibilities
- Lead, supervise, and direct the Care Access team, setting daily priorities and managing department workflows and operations in alignment with MassHealth regulations, including 130 CMR 408.000, and Vitra Health policies.
- Ensure staff training is completed on schedule and identify opportunities for the professional development of each team member.
- Oversee timely follow-up by the Care Access team with hospitals, physician offices, and other referral sources.
- Lead document integrity by ensuring that all intake and client documentation, including provider orders and clinical notes, is complete, accurate, and submitted on time.
- Drive the timely conversion of referrals into active clients, monitoring key performance indicators to keep the department’s admission times within target.
- Use Vitra’s electronic dashboard to track each client’s progress from assessment to admission and confirm that all compliance targets are met.
- Ensure verification of MassHealth and managed care eligibility and identify and resolve eligibility issues early in the intake process.
- Coordinate with Nurse Case Managers to schedule initial assessments and reassessments and ensure that required visits are completed on time.
- Oversee the tracking of initial and ongoing prior authorizations (PAs), collaborating with other departments to prevent any gap in client care.
- Ensure the Care Access team escalates issues with authorization documents and payers promptly so that services are not interrupted.
- Take initiative in directing client interactions, maintaining professional and consistent communication with prospective clients by phone, email, text, and mail at appropriate intervals.
- Serve as a knowledgeable resource on Vitra Health’s program offerings, competitive advantages, and operational workflows for referral sources, prospective clients, and families.
- Identify qualified caregivers for Family Care programs and coordinate with the credentialing team to complete caregiver credentialing.
- Resolve client concerns and barriers to service promptly, with client satisfaction as the guiding priority.
- Maintain the highest standard of confidentiality for all protected health information, in accordance with HIPAA and Vitra Health privacy policies.
Foster a culture of customer service and commitment to quality care:
- Serve as a brand ambassador for Vitra reflecting our vision, mission, and values.
- Show genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members.
- Mentor and support team members.
- Other duties as assigned.
What We Are Looking For
- Associate’s degree or an equivalent combination of education and experience required; Bachelor’s degree strongly preferred.
- At least 3 years of experience in healthcare intake, care coordination, or a related administrative role, including at least one year leading or supervising a team.
- Fluency in Spanish, written and spoken preferred.
- Experience with MassHealth, Adult Foster Care (AFC), Group Adult Foster Care (GAFC), or home care programs preferred, including eligibility verification and prior authorization processes.
- Familiarity with CRM and EHR systems, such as Salesforce.
- Strong organizational and follow-up skills, with the ability to manage multiple cases at the same time.
- Excellent written and verbal communication skills.
