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…