Supervisor of Medicaid Compliance and Accountability

SPECIAL EDUCATION OFFICE; Martinsburg (WV); On-site; USD 70,000 - 100,000; Full time

Job summary

Berkeley County Schools in West Virginia seeks a Supervisor of Medicaid Compliance and Accountability to lead district-wide Medicaid participation, compliance, and documentation. The role oversees audits, reporting, and continuous improvement across schools and departments, coordinating with transportation, nursing, therapy, and finance teams.

The incumbent chairs the Medicaid Team, ensures training, monitors billing trends, and communicates requirements to affected staff while upholding

Qualifications

• Master’s degree in Special Education, Educational Leadership, School Administration, Healthcare Administration, Nursing, or a related field is preferred.
• Minimum of three years of successful experience in special education, related services, school-based Medicaid, educational administration, healthcare administration, finance, auditing, or regulatory compliance is preferred.
• Demonstrated knowledge of IDEA, school-based Medicaid, related services, documentation, billing, reimbursement, and regulatory compliance.
• Ability to analyze data, conduct compliance reviews, develop procedures, identify trends, and implement continuous improvement strategies.
• Strong leadership, organizational, communication, training, problem‑solving, and interpersonal skills.
• Ability to work collaboratively with district personnel, families, healthcare providers, consultants, and external agencies.
• Ability to maintain confidentiality and exercise sound professional judgment when handling protected student, personnel, medical, and financial information.

Responsibilities

• Provide district-wide oversight of Medicaid participation, service delivery, documentation, billing, reimbursement, and compliance activities.
• Develop and update district Medicaid procedures, manuals, handbooks, forms, and guidance.
• Ensure compliance with federal/state Medicaid requirements and IDEA.
• Conduct internal audits and compliance reviews of provider records and billing practices.
• Develop annual Medicaid audit schedules and respond to external audits and program reviews.
• Maintain licenses, certifications, credentials, and enrollment status for Medicaid providers.
• Establish procedures for accurate data across district systems and monitor participation and billing.

Skills

Data analysis

Leadership

Communication

Problem-solving

Education

Master’s degree (Special Education / Educational Leadership / School Administration / Healthcare Administration / Nursing)

Job description

Supervisor of Medicaid Compliance and Accountability

Starting Date: Immediately

Job Description

Position: Supervisor of Medicaid Compliance and Accountability
Location: Central Office – Multi-Location

Supervisor: Executive Director of Special Education
Salary: Coordinator Index, based on degree and years of experience
Length of Employment: 230 Days – Flexible Schedule

Supervises: District Medicaid processes and assigned program activities; provides functional oversight and guidance to designated personnel

Job Goal

The Supervisor of Medicaid Compliance and Accountability serves as Berkeley County Schools’ Medicaid Manager and primary district contact for the school-based Medicaid program. The supervisor provides district-wide leadership for Medicaid participation, compliance, documentation, billing, training, data integrity, service delivery, fiscal accountability, internal auditing, and continuous improvement.

The supervisor chairs the district Medicaid Team and coordinates representatives from Speech-Language Pathology, Physical Therapy, Occupational Therapy, School Psychology, Nursing, Transportation, Pre‑K, EPIC/ E School Docs , Finance, and other appropriate departments . The team supports the implementation and monitoring of the district’s Medicaid procedures, participation requirements, training, service delivery, documentation, billing, and compliance activities.

The supervisor also serves as the central point of communication for school-based Medicaid contacts and works with schools, departments, providers, administrators, and external agencies to maintain compliance, increase participation, improve service delivery, and maximize allowable Medicaid reimbursement.

Qualifications

• A master’s degree in Special Education , Educational Leadership, School Administration, Healthcare Administration, Nursing, or a related field is preferred.
• A minimum of three years of successful experience in special education, related services, school-based Medicaid, educational administration, healthcare administration, finance, auditing, or regulatory compliance is preferred.
• Demonstrated knowledge of the Individuals with Disabilities Education Act, school-based Medicaid, related services, documentation, billing, reimbursement, and regulatory compliance.
• Demonstrated ability to analyze data, conduct compliance reviews, develop procedures, identify trends, and implement continuous improvement strategies.
• Strong leadership, organizational, communication, training, problem-solving, and interpersonal skills.
• Ability to work collaboratively with district personnel, families, healthcare providers, consultants, and external agencies.
• Ability to maintain confidentiality and exercise sound professional judgment when handling protected student , personnel, medical, and financial information.

Knowledge Of

• Federal and state Medicaid requirements applicable to school-based services.
• Individualized Education Programs, related services, procedural safeguards, and IDEA requirements.
• Medicaid documentation, billing, reimbursement, auditing, monitoring, and corrective action processes.
• Medicaid-eligible services, including related services, nursing, transportation, Targeted Case Management, and other approved services.
• Random Moment Time Study requirements and procedures.
• WVEIS, E-School Docs, EPIC , and other district-approved Medicaid and special education systems.
• Provider licensure, certification, qualification, and enrollment requirements.
• FERPA, HIPAA, Medicaid confidentiality requirements, and Berkeley County Schools policies.

General Duties and Responsibilities

Medicaid Team Leadership and District Coordination

• Serve as Berkeley County Schools’ Medicaid Manager, primary district Medicaid contact, and central point of communication for schools, departments, providers, administrators, and external agencies.
• Chair and facilitate monthly meetings of the district Medicaid Team.
• Coordinate team representatives from Speech-Language Pathology, Physical Therapy, Occupational Therapy, School Psychology, Nursing, Transportation, Pre‑K, EPIC/ E School Docs, Finance, and other departments asappropriate.
• Lead the Medicaid Teamto reviewparticipation rates, services provided, billing trends, training needs, regulatory updates, compliance concerns, audit findings, and departmental issues.
• Coordinate the specialized input of team membersregardingrelated services, transportation, RMTS, Targeted Case Management, coding, data systems, finance, and billing.
• Communicatethe purpose, requirements, and value of school-based Medicaid and reinforce district expectations for eligible staff and departmental participation.

Program Oversight and Compliance

• Provide district-wide oversight of Medicaid participation, service delivery, documentation, billing, reimbursement, and compliance activities.
• Develop, implement, monitor, and update district Medicaid procedures, manuals, handbooks, forms, compliance flowcharts, and operational guidance.
• Ensure compliance with applicable federal andstateMedicaid requirements, IDEA, West Virginia Department of Education requirements, and Berkeley County Schools policies.
• Conduct internal audits and compliance reviews of provider records, service logs, billing practices, student records, transportation documentation, and supporting records.
• Develop and implement an annual Medicaid audit schedule for schools, departments, providers, transportation services, and billing records.
• Coordinate responses to external audits,monitoringvisits, program reviews, and requests for documentation.
• Develop andmonitorcorrective action plans and implement recommendations resulting from audits, reviews, consultants, oridentifieddeficiencies.
• Ensure Medicaid providersmaintainrequired licenses, certifications, qualifications, credentials, and enrollment status.

Data, Documentation, and Reporting

• Establish procedures to ensureaccurateand consistent student, provider, consent, service, participation, and billing data across district systems.
• Use information from WVEIS, E-School Docs, EPIC,E Schools Docs , Medicaid billing systems, and other approved systems to monitor participation, service delivery, documentation, and billing.
• Collect, verify, and report monthly student, provider, caseload, consent, participation, service-delivery, and billing data from schools and departments.
• Monitor RMTS participation, response timelines, follow-up requirements, and compliance with state deadlines.
• Monitor Targeted Case Management forparticipation, documentation, service delivery, and billing opportunities.
• Develop dashboards and performance indicators tomonitorparticipation rates, reimbursement, documentation compliance, claim denials, rejected claims, and missed billing opportunities.
• Identifysignificant increases or decreases in billing and participation by school, department, service area, and transportation program and recommend corrective or improvement actions.
• Provide monthly Medicaid reports to the Superintendent, Chief Financial Officer, and Executive Director of Special Education, including reimbursement generated, participation rates, billing trends, compliance concerns, corrective actions, and program successes.

Service Delivery and Related Services Oversight

• Review provider schedules, caseloads, workload assignments, and service-delivery records to support IEP compliance,equitablestaffing, efficient use of personnel, andtimelyservices.
• Develop andmonitorprocedures for obtaining, tracking,maintaining, and uploading Medicaid parent consent documentation.
• Develop procedures foridentifyingand addressing missed services, incomplete documentation, scheduling concerns, andservice-deliveryissues.
• Monitor district-wide implementation of Medicaid-eligible services, including related services, nursing, psychology, audiology, transportation, and other approved services.
• Coordinate with Transportation and Special Education tomonitorMedicaid-eligible transportation services,requireddocumentation, van billing procedures, and reimbursement opportunities.
• Collaborate with administrators, coordinators, supervisors, and providers to resolve service-delivery, documentation, staffing, and compliance concerns.
• Assistwith recommendations and oversight related to contracted providers and outside agencies delivering special education or related services.

Training and School-Based Support

• Develop and provide ongoing professional development, in-service training, written guidance, examples, and technicalassistancerelated to Medicaid participation, documentation, billing, service-delivery, and compliance.
• Establish, train, and supporta Medicaidcontact at each school.
• Serve as the key district contact for school-based Medicaid contacts andmaintaina consistent communication and follow-up structure between schools and the central office.
• Communicate changes in Medicaid regulations, billing requirements, documentation standards, state guidance, and district procedures to affected personnel.

Fiscal Management and Program Improvement

• Collaborate with Finance and billing personnel to ensuretimely,accurate, complete, and compliant submission of Medicaid claims and resolution of denied or rejected claims.
• Analyze reimbursement and participation trends,identifymissed billing opportunities, forecast Medicaid revenue, and recommend strategies to maximize allowable reimbursement whilemaintainingcompliance.
• Stay current on Medicaid requirements,maintainconfidentiality and organized records, support continuous improvement initiatives, and perform other duties assigned by the Executive Director of Special Education.

Performance Indicators

Performance may be evaluated through indicators that include:

• Increased participation in eligible Medicaid programs and services.
• Increasedappropriate Medicaidreimbursement.
• Improved compliance with Medicaid regulations and district procedures.
• Reduced audit findings, documentation deficiencies, questioned costs, and corrective actions.
• Improved provider participation andtimelydocumentation.
• Increased accuracy across district data and billing systems.
• Improved RMTS and Targeted Case Management participation.
• Reduced claim denials, rejected claims, and missed billing opportunities.
• Effective monthly operation of the district Medicaid Team.
• Timely andaccuratemonthly reporting to district leadership.
• Effective communication and support through school-based Medicaid contacts.
• Improved fiscal stewardship and sustainability of the district Medicaid program.
• Evidence that eligible students receive required servicesin accordance withtheir Individualized Education Programs.

Supervisor of Medicaid Compliance and Accountability

Berkeley County Schools (WV) Special Education Department - Martinsburg, West Virginia Open in Google Maps

This job is also posted in Berkeley County Schools

Job Details

Job ID: 5844750
Application Deadline: Nov 18, 2026 11:59 PM (Eastern Standard Time)
Re-Posted: Nov 04, 2026 5:00 AM (UTC)

Starting Date: Immediately

Job Description

Position: Supervisor of Medicaid Compliance and Accountability
Location: Central Office – Multi-Location

Supervisor: Executive Director of Special Education
Salary: Coordinator Index, based on degree and years of experience
Length of Employment: 230 Days – Flexible Schedule

Supervises: District Medicaid processes and assigned program activities; provides functional oversight and guidance to designated personnel

Job Goal

The Supervisor of Medicaid Compliance and Accountability serves as Berkeley County Schools’ Medicaid Manager and primary district contact for the school-based Medicaid program. The supervisor provides district-wide leadership for Medicaid participation, compliance, documentation, billing, training, data integrity, service delivery, fiscal accountability, internal auditing, and continuous improvement.

The supervisor chairs the district Medicaid Team and coordinates representatives from Speech-Language Pathology, Physical Therapy, Occupational Therapy, School Psychology, Nursing, Transportation, Pre‑K, EPIC/ E School Docs , Finance, and other appropriate departments . The team supports the implementation and monitoring of the district’s Medicaid procedures, participation requirements, training, service delivery, documentation, billing, and compliance activities.

The supervisor also serves as the central point of communication for school-based Medicaid contacts and works with schools, departments, providers, administrators, and external agencies to maintain compliance, increase participation, improve service delivery, and maximize allowable Medicaid reimbursement.

Qualifications

• A master’s degree in Special Education , Educational Leadership, School Administration, Healthcare Administration, Nursing, or a related field is preferred.
• A minimum of three years of successful experience in special education, related services, school-based Medicaid, educational administration, healthcare administration, finance, auditing, or regulatory compliance is preferred.
• Demonstrated knowledge of the Individuals with Disabilities Education Act, school-based Medicaid, related services, documentation, billing, reimbursement, and regulatory compliance.
• Demonstrated ability to analyze data, conduct compliance reviews, develop procedures, identify trends, and implement continuous improvement strategies.
• Strong leadership, organizational, communication, training, problem-solving, and interpersonal skills.
• Ability to work collaboratively with district personnel, families, healthcare providers, consultants, and external agencies.
• Ability to maintain confidentiality and exercise sound professional judgment when handling protected student , personnel, medical, and financial information.

Knowledge Of

• Federal and state Medicaid requirements applicable to school-based services.
• Individualized Education Programs, related services, procedural safeguards, and IDEA requirements.
• Medicaid documentation, billing, reimbursement, auditing, monitoring, and corrective action processes.
• Medicaid-eligible services, including related services, nursing, transportation, Targeted Case Management, and other approved services.
• Random Moment Time Study requirements and procedures.
• WVEIS, E-School Docs, EPIC , and other district-approved Medicaid and special education systems.
• Provider licensure, certification, qualification, and enrollment requirements.
• FERPA, HIPAA, Medicaid confidentiality requirements, and Berkeley County Schools policies.

General Duties and Responsibilities

Medicaid Team Leadership and District Coordination

• Serve as Berkeley County Schools’ Medicaid Manager, primary district Medicaid contact, and central point of communication for schools, departments, providers, administrators, and external agencies.
• Chair and facilitate monthly meetings of the district Medicaid Team.
• Coordinate team representatives from Speech-Language Pathology, Physical Therapy, Occupational Therapy, School Psychology, Nursing, Transportation, Pre‑K, EPIC/ E School Docs, Finance, and other departments asappropriate.
• Lead the Medicaid Teamto reviewparticipation rates, services provided, billing trends, training needs, regulatory updates, compliance concerns, audit findings, and departmental issues.
• Coordinate the specialized input of team membersregardingrelated services, transportation, RMTS, Targeted Case Management, coding, data systems, finance, and billing.
• Communicatethe purpose, requirements, and value of school-based Medicaid and reinforce district expectations for eligible staff and departmental participation.

Program Oversight and Compliance

• Provide district-wide oversight of Medicaid participation, service delivery, documentation, billing, reimbursement, and compliance activities.
• Develop, implement, monitor, and update district Medicaid procedures, manuals, handbooks, forms, compliance flowcharts, and operational guidance.
• Ensure compliance with applicable federal andstateMedicaid requirements, IDEA, West Virginia Department of Education requirements, and Berkeley County Schools policies.
• Conduct internal audits and compliance reviews of provider records, service logs, billing practices, student records, transportation documentation, and supporting records.
• Develop and implement an annual Medicaid audit schedule for schools, departments, providers, transportation services, and billing records.
• Coordinate responses to external audits,monitoringvisits, program reviews, and requests for documentation.
• Develop andmonitorcorrective action plans and implement recommendations resulting from audits, reviews, consultants, oridentifieddeficiencies.
• Ensure Medicaid providersmaintainrequired licenses, certifications, qualifications, credentials, and enrollment status.

Data, Documentation, and Reporting

• Establish procedures to ensureaccurateand consistent student, provider, consent, service, participation, and billing data across district systems.
• Use information from WVEIS, E-School Docs, EPIC,E Schools Docs , Medicaid billing systems, and other approved systems to monitor participation, service delivery, documentation, and billing.
• Collect, verify, and report monthly student, provider, caseload, consent, participation, service-delivery, and billing data from schools and departments.
• Monitor RMTS participation, response timelines, follow-up requirements, and compliance with state deadlines.
• Monitor Targeted Case Management forparticipation, documentation, service delivery, and billing opportunities.
• Develop dashboards and performance indicators tomonitorparticipation rates, reimbursement, documentation compliance, claim denials, rejected claims, and missed billing opportunities.
• Identifysignificant increases or decreases in billing and participation by school, department, service area, and transportation program and recommend corrective or improvement actions.
• Provide monthly Medicaid reports to the Superintendent, Chief Financial Officer, and Executive Director of Special Education, including reimbursement generated, participation rates, billing trends, compliance concerns, corrective actions, and program successes.

Service Delivery and Related Services Oversight

• Review provider schedules, caseloads, workload assignments, and service-delivery records to support IEP compliance,equitablestaffing, efficient use of personnel, andtimelyservices.
• Develop andmonitorprocedures for obtaining, tracking,maintaining, and uploading Medicaid parent consent documentation.
• Develop procedures foridentifyingand addressing missed services, incomplete documentation, scheduling concerns, andservice-deliveryissues.
• Monitor district-wide implementation of Medicaid-eligible services, including related services, nursing, psychology, audiology, transportation, and other approved services.
• Coordinate with Transportation and Special Education tomonitorMedicaid-eligible transportation services,requireddocumentation, van billing procedures, and reimbursement opportunities.
• Collaborate with administrators, coordinators, supervisors, and providers to resolve service-delivery, documentation, staffing, and compliance concerns.
• Assistwith recommendations and oversight related to contracted providers and outside agencies delivering special education or related services.

Training and School-Based Support

• Develop and provide ongoing professional development, in-service training, written guidance, examples, and technicalassistancerelated to Medicaid participation, documentation, billing, service-delivery, and compliance.
• Establish, train, and supporta Medicaidcontact at each school.
• Serve as the key district contact for school-based Medicaid contacts andmaintaina consistent communication and follow-up structure between schools and the central office.
• Communicate changes in Medicaid regulations, billing requirements, documentation standards, state guidance, and district procedures to affected personnel.

Fiscal Management and Program Improvement

• Collaborate with Finance and billing personnel to ensuretimely,accurate, complete, and compliant submission of Medicaid claims and resolution of denied or rejected claims.
• Analyze reimbursement and participation trends,identifymissed billing opportunities, forecast Medicaid revenue, and recommend strategies to maximize allowable reimbursement whilemaintainingcompliance.
• Stay current on Medicaid requirements,maintainconfidentiality and organized records, support continuous improvement initiatives, and perform other duties assigned by the Executive Director of Special Education.

Performance Indicators

Performance may be evaluated through indicators that include:

• Increased participation in eligible Medicaid programs and services.
• Increasedappropriate Medicaidreimbursement.
• Improved compliance with Medicaid regulations and district procedures.
• Reduced audit findings, documentation deficiencies, questioned costs, and corrective actions.
• Improved provider participation andtimelydocumentation.
• Increased accuracy across district data and billing systems.
• Improved RMTS and Targeted Case Management participation.
• Reduced claim denials, rejected claims, and missed billing opportunities.
• Effective monthly operation of the district Medicaid Team.
• Timely andaccuratemonthly reporting to district leadership.
• Effective communication and support through school-based Medicaid contacts.
• Improved fiscal stewardship and sustainability of the district Medicaid program.
• Evidence that eligible students receive required servicesin accordance withtheir Individualized Education Programs.

Position Type: Full-Time

Job Requirements

• Citizenship, residency or work visa required

Contact Information

• Lee-Dorah Wokpara , Coordinator of Recruitment
• Berkeley County Schools
• Martinsburg, West Virginia 25405
• Phone: [phone]
• Email: [e-mail]

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