Examples of Service coordination in a sentence
MCOs must satisfy all Readiness Review requirements no later than 60 days prior to the Operational Start Date for each applicable MCO Program and Service Area, with the exception of HHSC’s review of the Service Coordination function.
A STAR+PLUS MCO must demonstrate that there are sufficient levels of qualified and competent personnel devoted to Service Coordination to meet the everyday needs of STAR+PLUS Members, including Dual Eligibles.
Key personnel include: Executive Director (as defined in Attachment A, Article 4), Medical Director (as defined in Attachment A, Article 4), Member Services Manager, Service Coordination Manager (STAR+PLUS only), Management Information Systems Manager, Claims Processing Manager, Provider Network Development Manager, Benefit Administration and Utilization Management Manager, Quality Improvement Manager, Behavioral Health Services Manager, Financial Functions Manager, and Reporting Manager.
If the Member refuses Service Coordination, the MCO should document the refusal in the Member's case file.
At a minimum, the MCO will have three tiers of Service Coordination for all Members.