The Department of Health and Human Services, is looking for a self-motivated individual to provide program accuracy leadership for Medicaid Programs within the Division of Medicaid and Long-Term Care.
Under limited supervision is responsible for supervision, direction of work, developing and providing direct training (including on-the-job observation and evaluation) of Program Accuracy Specialist in the Division of Medicaid and Long-Term Care. Conducting third level quality assurance reviews of case management activities. Monitors case reviews and reports completed by assigned staff to determine the adequacy of documentation and findings. Consults with assigned staff to clarify and explain rules, regulations, and procedures of the Medicaid program. Makes recommendations based on the findings of assigned staff for the correction of problems identified in the assigned program areas and complete required state and federal reporting. Assists in the implementation and coordination of Medicaid policy and program regulations with field staff and management staff to ensure uniform application of policy and procedures. Coordinates the collection and analysis of data, identifies barriers and quality improvement approaches, and/or program evaluations methods. May require overnight travel.
REQUIREMENTS: Bachelors degree or equivalent coursework/training in: public administration, business or social behavioral sciences or other field related to the assigned program or professional experience working in a human/social service or health care agency including experience writing for grants, administering funds and leading community groups.
PREFERRED: Three to five years experience in a health and/or human services field or public service organization with responsibility for determining eligibility for Medicaid programs, assessing public assistance needs, or case management using program rules and regulations OR 24 post high school coursework/training in: social or behavioral science, business/public administration, Management or closely related area AND experience with Medicaid regulations. Experience supervising, leading, monitoring and/or directing others. Experience with data analysis, quality improvement approaches, and/or program evaluations methods.
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