The Vendor is required to provide a wide variety of medicaid benefits including coverage for long-term services and support (LTSS) by providing services in an institution (e.g., nursing facility) and through CCC plus waiver.
- The LTSS Screening process is to:
• Evaluate the medical, nursing, developmental, psychological, and social needs of each individual believed to be in need of or at risk of nursing facility admission.
• Analyze specific services that the individual needs.
• Evaluate whether a service or a combination of existing community services is available to meet the individual’s needs; and
• Determine the level-of-care required by the individual by applying existing criteria for nursing facilities and HCBS waiver services.
• The volume of community-based LTSS Screenings for children continues to increase.
- The Medicaid Management Information System (MMIS) is the computer system used to store enrollees and provider information, issue benefits, and track claims data.
- Ability to track a variety of customer service calls, requests for screenings, document scanning of received documents, provide general program information, reporting intake data, and complaint and issue resolution
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