Medicaid Program Manager

Staffing Solutions Organization LLC (SSO); City of Albany (NY); On-site; USD 85,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k) with discretionary employer mix

Paid time off and holidays

Flexible spending accounts

Additional employee perks

Job summary

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is seeking a Medicaid Program Manager in Albany, NY. You will support the Center for Home and Community Based Services, overseeing NHTD and TBI Medicaid Waiver Programs to ensure CMS compliance and improve participant outcomes.

The role emphasizes quality assurance, regulatory management, technical assistance, and stakeholder engagement with RRDCs and service providers to drive program efficiency and

Qualifications

• Bachelor's degree and equivalent professional experience, or a combination of education and experience.
• 10+ years of professional experience in healthcare administration, Medicaid programs, human services, long-term care, public health, or a related field.
• 5+ years of subject matter expertise in Medicaid, waiver programs, managed care, healthcare compliance, or related program operations.
• Demonstrated supervisory or team leadership experience.
• Experience managing complex investigations, case reviews, compliance activities, or quality assurance initiatives.

Responsibilities

• Oversee and manage quality assurance activities for the NHTD and TBI Waiver Programs.
• Lead the waiver participant complaint process, ensuring timely investigation and resolution of concerns.
• Serve as the primary point of contact for waiver participant cases.
• Investigate participant complaints, critical incidents, abuse, neglect, and participant harm allegations.
• Collaborate with Regional Resource Development Centers (RRDCs), Service Coordinators, and provider agencies to address and resolve participant concerns.
• Ensure waiver program compliance with federal CMS standards and regulations.
• Interact with CMS staff and external stakeholders regarding waiver operations and regulatory requirements.
• Monitor program performance and identify opportunities for continuous quality improvement.

Skills

Leadership

Communication

Analytical thinking

Problem solving

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Excel

PowerPoint

Job description

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Medicaid Program Manager

Office of Aging & Long-Term Care

Location: Albany, NY

Schedule: Hybrid (50% Onsite / 50% Remote)

Salary Range: $85,000 - $93,600

About the Opportunity

The Office of Aging & Long-Term Care is seeking a Medicaid Program Manager to support the Center for Home and Community Based Services in its mission to rebalance New York State's long-term care system from institutional care to home and community-based services.

This position plays a critical role in supporting the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Medicaid Waiver Programs. The successful candidate will help ensure compliance with Centers for Medicare & Medicaid Services (CMS) requirements while overseeing participant complaint resolution, quality assurance initiatives, and stakeholder engagement efforts that enhance service delivery and participant outcomes.

Key Responsibilities

Quality Assurance & Program Oversight

• Oversee and manage quality assurance activities for the NHTD and TBI Waiver Programs.
• Lead the waiver participant complaint process, ensuring timely investigation and resolution of concerns.
• Serve as the primary point of contact for waiver participant cases.
• Investigate participant complaints, critical incidents, abuse, neglect, and participant harm allegations.
• Collaborate with Regional Resource Development Centers (RRDCs), Service Coordinators, and provider agencies to address and resolve participant concerns.

Compliance & Regulatory Management

• Ensure waiver program compliance with federal CMS standards and regulations.
• Interact with CMS staff and external stakeholders regarding waiver operations and regulatory requirements.
• Monitor program performance and identify opportunities for continuous quality improvement.

Technical Assistance & Stakeholder Engagement

• Provide technical assistance and guidance to RRDCs, program service agencies, and internal Department of Health teams.
• Interpret and clarify waiver policies, procedures, and program manuals.
• Identify opportunities for stakeholder education and participant engagement.
• Serve as a liaison across Department of Health bureaus to support coordinated program operations.

Reporting & Operational Improvement

• Conduct periodic reviews of waiver service quality and participant outcomes.
• Develop reports, recommendations, and program analyses for leadership.
• Identify operational efficiencies and process improvement opportunities.
• Facilitate meetings and present findings to internal and external stakeholders.

Required Qualifications

• Bachelor's degree and equivalent professional experience, or a combination of education and experience.
• 10+ years of professional experience in healthcare administration, Medicaid programs, human services, long-term care, public health, or a related field.
• 5+ years of subject matter expertise in Medicaid, waiver programs, managed care, healthcare compliance, or related program operations.
• Demonstrated supervisory or team leadership experience.
• Experience managing complex investigations, case reviews, compliance activities, or quality assurance initiatives.

Preferred Qualifications

• Experience with Home and Community-Based Services (HCBS), Medicaid Waiver Programs, NHTD, TBI, or long-term services and supports (LTSS).
• Knowledge of CMS regulations and Medicaid program requirements.
• Strong written and verbal communication skills.
• Excellent organizational, analytical, and problem‑solving abilities.
• Experience facilitating meetings and collaborating with diverse stakeholder groups.
• Advanced proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
• Ability to prepare detailed reports, executive summaries, and presentations for leadership.

Benefits (Through SSO)

SSO offers a competitive benefits package that supports your health, financial well‑being, and long‑term growth, including:

• Medical, dental, and vision insurance
• 401(k) with discretionary employer match
• Paid time off and holidays
• Flexible spending accounts
• Additional employee perks

Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.

Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H‑1B sponsorship) by SSO and under the federal laws relating to the F‑1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E‑Verify participant.