Supervisor Medicaid Waiver

Supervisor, Medicaid Waiver

Starting Salary Range: $75,518 - $90,621

GGRC is looking to hire a Supervisor, Medicaid Waiver who will acts as a supervisor for Medicaid Waiver (MW) Program, including determining MW eligibility for persons served and overseeing and coordinating the Medicaid Waiver program requirements throughout the Agency. Researches and resolves Medicaid Waiver related issues and provides information for management and other units as requested. Supervises staff and potentially outside consultants.

This position will require regional travel within the Counties of San Francisco, San Mateo and Marin, and Northern/Central California, including Sacramento.

Access to reliable transportation permitting travel to and between many different locations throughout the day in order to perform the outlined responsibilities of the position.

Responsibilities

• Administration of Medicaid Waiver Program
• Review case records to assure all qualifying conditions are supported by current case documentation
• Perform recertification for individuals who are eligible for Medicaid Waiver
• Document, in accordance with the Medicaid Waiver Manual, all Medicaid Waiver persons served
• Provide quality assurance in collaboration with case manager, assuring that all case records meet Medicaid Waiver standards for content and consistency
• Inform, educate and provide input to case management staff and other necessary staff regarding Medicaid Waiver documentation and any changes in Medicaid Waiver status persons served
• Function as a resource person to case management staff in the development of Medicaid Waiver related goals and objectives for persons served in their Individual Program Plan (IPP).
• ·Supervision of Medicaid Waiver Program
• Ensure enrollment goals are met to secure maximum funding for the agency
• Monitors the review of case records to assure MW level CDER assessed needs of persons served are supported by current case file documentation
• Instruct, coach and monitor GGRC staff regarding Medicaid Waiver documentation requirements and any changes in Medicaid Waiver status of persons served
• Coordinate quality assurance and training for the case management staff to assure that all case records adhere to and comply with Medicaid Waiver requirements
• Act as primary GGRC liaison with all Medicaid Waiver related external organizations including DDS and County Health and Human Services Offices
• Refer, coordinate and follow up with Institutional Deeming Referrals
• Ensure that diagnostic CDER is updated and accurate
• Participate in ARCA Federal Programs committee meetings
• Audits
• Develop Audit protocols and coordinate file reviews
• Review all Audit reports
• Present audit findings to manager
• Coordinate GGRC responses to audit cases
• Develop internal controls and develop/oversee corrective action plans to resolve outstanding audit issues
• Research and develop case materials and strategy for audit appeals
• Represents GGRC on audit appeals cases
• Staff Management
• Interview, hire, train and supervise staff
• Provide staff with guidance and feedback on performance
• Hold periodic staff meetings to disseminate information and provide opportunities for feedback on procedures
• Manage work flow and staff time/work coverage ensuring individual and unit goals are being met
• Training/Development
• Maintain expertise in external regulations through appropriate formal and self-directed training
• Oversees the development of manuals, policies and procedures regarding Medicaid Waiver
• Develop curriculum and conduct staff trainings on new and updated regulations, policies and procedures
• Advise staff on procedures and help resolve specific program issues
• Conduct regular orientations for incoming staff
• Participate in special projects, and assist with additional duties or tasks, as assigned
• Maintain all information as confidential in compliance with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Lanterman Act

Requirements

• Education/Experience
• Bachelor’s Degree in Nursing or other related field
• 5+ years professional experience in health care, health administration or social services including one year of direct services to people with developmental disabilities preferred
• 3+ years professional experience supervising professional staff
• Skills
• Strong Leadership skills
• Training and facilitation
• Ability to understand Agency’s vision and values and implement changes within the unit to support it
• Ability to work with all levels within the organization
• Knowledge of Medicaid Waiver regulations and GGRC Case Management principles and procedures.
• Ability to convey complex information and ideas in a clear, concise and professional manner
• Proficiency in project management skills
• Strong attention to detail and analytical skills
• Intermediate knowledge of MS Word®, MS Excel®, MS PowerPoint®, MS Outlook® or similar software applications
• Competency Traits
• Provide team with direction and purpose focused on quality, efficiency and outcomes
• Foster environment of customer service
• Coach and support staff by making self accessible and providing real-time feedback
• Address performance and hold people accountable
• Problem identification and analysis; analytical thinking
• Successful implementation through follow-up and project management
• Self direction and initiative
• Demonstrate respect and cultural awareness; effectively manage own reactions
• Build partnerships and trust through collaboration, active listening and an openness to new ideas
• Understand and effectively react/adapt to multiple and competing priorities on the job; use knowledge and expertise to focus on key job outcomes
• Desired Qualifications
• Familiarity with Medicaid Waiver Regulations and Case Management Procedure
• Experience in multi-cultural settings and/or multi-lingual capacity