Specifications include, but are not limited to: The Member Support Services Contractor is needed to educate members and support them in obtaining services through their Indiana Pathways for Aging plan should they encounter any issues. The primary goal of the MSS vendor will be to provide members with education, advocacy, and support to navigate and resolve issues they experience while enrolled in Pathways for Aging, including those issues escalated through the grievance and appeals process. Support activities include, but are not limited to: Educating members about managed care operations and how to access services, educating members about MCE responsibilities to members, serving as a mediator between MCE and member when needed, educating and supporting members through the Grievance and Appeals process, submitting Appeals to the MCE on behalf of member if needed, educating and supporting members as they prepare for a state fair hearing, providing referrals to other support entities as appropriate. The Contractor will also provide reporting to FSSA including the identification of systemic issues, which will aid FSSA's Pathways compliance activities
