Job Description

Position Summary:

Rutgers, The State University of New Jersey has opening for a Public Health Representative II for the World Trade Center Health Program ( WTCHP ) within the Environmental and Occupational Health Sciences Institute, located in Piscataway, NJ. Under supervision, participates in the administration of the federally contracted World Trade Center Health Program at Rutgers, the Public Health Representative prepares, submits, and manages certification requests in accordance with contractual requirements; conducts referral and pre-authorization requests to in network specialty providers; and works across the healthcare spectrum to coordinate patient care in adherence with programmatic guidelines and quality objectives.
Duties include:

• Prepares, submits, and manages certification request submissions for the World Trade Health Program Clinical Center at Rutgers in accordance with CDC contractual guidelines. Interfaces with appropriate healthcare and governmental entities to ensure submissions are accurate and complete. Tracks and reports on status of submissions on a regular basis.
• Receives and manages incoming calls from patients and providers regarding certification requests, program benefits, and other member services related inquiries. Details actions and outcomes in the appropriate databases.
• Conducts referral and pre-authorization requests to in network specialty providers. Reviews incoming requests for administrative compliance with the WTC Health Program codebook.
• Provides education to program members, network providers, and interest groups on the World Trade Center Health Program. Assists in developing and disseminating educational materials in accordance with program initiatives. Supports retention initiatives.
• Assists in quality assurance initiatives for the World Trade Center Health Program. Upon request, conducts data analysis of cohort trends for use in contractual reporting.

City: Piscataway

State: NJ

Posting Number: 24ST2852

About Rutgers University

Rutgers, The State University of New Jersey, is a leading national public research university and the state's preeminent, comprehensive public institution of higher education. Rutgers is dedicated to teaching that meets the highest standards of excellence; to conducting research that breaks new ground; and to turning knowledge into solutions for local, national, and global communities. As it was at our founding in 1766, the heart of our mission is preparing students to become productive members of society and good citizens of the world. Rutgers teaches across the full educational spectrum: preschool to precollege; undergraduate to graduate and postdoctoral; and continuing education for professional and personal advancement. Rutgers is New Jersey's land-grant institution and one of the nation's foremost research universities, and as such, we educate, make discoveries, serve as an engine of economic growth, and generate ideas for improving people's lives.

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