Medicaid Program Manager - HCBS & Waiver Compliance

Staffing Solutions Organization LLC (SSO); City of Albany (NY); Hybrid; 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 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