Supervisor Medicaid Waiver

Golden Gate Regional Center Inc; San Francisco (CA); On-site; USD 76,000 - 91,000; Full time

Benefits offered by this job

Medical and Dental benefits

Employer 403(b) retirement plan

Generous time off

Job summary

Golden Gate Regional Center Inc (GGRC) seeks a Supervisor, Medicaid Waiver to manage the MW program, supervise staff and coordinate all MW requirements across the GGRC region. The role includes determining MW eligibility, ensuring QA, and acting as a liaison with DDS and County HHSA offices.

The position requires travel within San Francisco, San Mateo, Marin and broader Northern/Central California, including Sacramento, with a starting salary range of $75,518 to $90,621 per year.

Qualifications

• Bachelor's degree in Nursing or related field required.
• 5+ years in health care, health administration or social services preferred.
• 3+ years supervising professional staff.

Responsibilities

• Administration of Medicaid Waiver Program and ensuring documentation accuracy.
• Supervise staff and coordinate with external consultants as needed.
• Coordinate QA and training for case management staff on MW requirements.
• Represent GGRC in external Medicaid Waiver related activities and audits.

Skills

Leadership

Training facilitation

Policy knowledge

Communication

Project management

Education

Bachelor's Degree in Nursing or related field

Tools

MS Word

MS Excel

MS PowerPoint

MS Outlook

Job description

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

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

What are the benefits to working with GGRC?

• We offer a comprehensive benefits package including Medical and Dental benefits with a generous employer contribution and additional employer paid Life, Disability and Vision coverage
• 10% employer contribution to a 403(b) retirement account to help you save for the future!

GENEROUS TIME OFF BENEFITS!!!

No really, we mean generous:

• 13 vacation days, 15 sick days, 11 paid holidays, 6 personal days and up to 5 paid days for continuing education

What makes GGRC so special?

GGRC values diversity, we believe in creating an environment where people of all backgrounds can collaborate to find solutions to complex problems. We are community minded and passionate.

GGRC values each person as a full, robust, and unique individual and interacts with each person in a manner that is respectful and responsive. We endeavor to place each person at the center of his, her or their own life. We approach each person as an expert on his, her or their own life and identity with a clear and attentive inquiry into what is important to, as well as important for, that one person (whether coworker or person-served, family member or other stakeholder).

Golden Gate Regional Center is an Equal Opportunity Employer.