Waiver Specialist

SWMBH; Portage (MI); On-site; USD 55,000 - 75,000; Full time

Job summary

Southwest Michigan Behavioral Health is seeking a Waiver Specialist in Portage, MI to oversee HCBS waivers and Medicaid services, track enrollment and utilization, and support providers and CMHSPs.

The role reports to the Director of Quality and requires strong organization, communication, and data reporting skills with willingness to travel across service locations.

Qualifications

• Bachelor's in social work, psychology, organizational psychology, healthcare administration, or a human services field
• Strong organizational skills and attention to detail; tracks and reports data accurately
• Manages multiple projects and meets deadlines
• Strong oral and written communication and interpersonal skills; works well in teams and independently
• Willingness and ability to travel to all service locations
• Supports culturally competent, recovery-based, person-centered, and trauma-informed practices

Responsibilities

• Provide administrative oversight and coordination of HCBS waivers and Medicaid specialty services to ensure compliance
• Provide quality monitoring and oversight of LTSS and HCBS waivers
• Assist with PIHP oversight, including stratification of cases for waiver slot selection
• Serve as liaison between MDHHS and CMHSPs on regional and state needs and requirements
• Monitor service utilization, documentation timeliness, service access, and provider capacity
• Track waiver enrollment, utilization, and slot/capacity availability; prepare and submit accurate reports
• Guide providers and CMHSPs on administrative actions; refer quality concerns as needed
• Provide administrative training, follow-up, and technical assistance to providers and CMHSPs
• Identify programmatic concerns and notify senior leadership
• Stay current with applicable federal and state guidelines and accreditation standards
• May assist in drafting and reviewing policy and protocol

Skills

Data tracking

Attention to detail

Communication

Project management

Travel readiness

Education

Bachelor's in social work, psychology, healthcare administration, or related human services field

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Waiver Specialist

Clinical Quality Administration Full Time Portage, Michigan, Portage, MI, US

2 days ago Requisition ID: 1169

Salary Range: $55,080.00 To $74,520.00 Annually

Waiver Specialist

Southwest Michigan Behavioral Health • Quality & Clinical Outcomes • Office/Home

Reports To

Director of Quality

FLSA Status

Exempt

Compensation

Commensurate with experience

THE WAIVER SPECIALIST OPPORTUNITY

As our Waiver Specialist, you'll oversee federal Home and Community Based Services (HCBS) waivers and Medicaid specialty services across the region — tracking enrollment and utilization, supporting providers, and helping people get the services they need.

WHAT THE WAIVER SPECIALIST WILL OWN

• Administrative oversight of HCBS waivers (HSW, SED, CWP) and 1915(i) services
• Waiver enrollment, utilization, and slot/capacity tracking and reporting
• Liaison role between MDHHS and Community Mental Health Service Providers (CMHSPs)
• Provider and CMHSP training, technical assistance, and corrective actions

WHAT THE WAIVER SPECIALIST NEEDS TO BRING

• Bachelor's in social work, psychology, healthcare administration, or a related human services field
• Strong organization and attention to detail, with accurate data tracking and reporting
• Strong communication skills; able to manage multiple projects and deadlines

WAIVER SPECIALIST — FULL POSITION DETAILS

As part of the Prepaid Inpatient Health Plan (PIHP) benefits management system, the Waiver Specialist provides administrative and programmatic oversight of assigned federal HCBS waivers and Medicaid specialty services, including Habilitation Supports (HSW), Serious Emotional Disturbances (SED), the Children's Waiver Program (CWP), and 1915(i). The Waiver Specialist helps ensure compliance with Michigan Department of Health and Human Services (MDHHS) and PIHP requirements.

WAIVER SPECIALIST DUTIES & ESSENTIAL FUNCTIONS

• Provide administrative oversight and coordination of assigned HCBS waivers and Medicaid specialty services to ensure federal, state, contractual, and PIHP compliance
• Provide quality monitoring and oversight of Long-Term Services and Supports (LTSS) and HCBS waivers
• Assist with PIHP oversight, including stratification of cases for waiver slot selection
• Serve as liaison between MDHHS and CMHSPs on regional and state needs and requirements
• Monitor service utilization, documentation timeliness, service access, and provider capacity
• Track waiver enrollment, utilization, and slot/capacity availability; prepare and submit accurate, on-time reports to MDHHS and internal leadership
• Guide providers and CMHSPs on administrative and procedural corrective actions; refer clinical performance or quality-of-care matters to the Clinical Quality Specialist
• Provide administrative training, follow-up, and technical assistance to providers and CMHSPs
• Identify programmatic or administrative concerns and notify Senior Leadership and oversight committees
• Stay current with, and comply with, applicable federal and state guidelines and accreditation standards
• May assist in drafting and reviewing policy and protocol

WAIVER SPECIALIST QUALIFICATIONS

Required

• Bachelor's in social work, psychology, organizational psychology, healthcare administration, or a human services field
• Strong organizational skills and attention to detail; tracks and reports data accurately
• Manages multiple projects and meets deadlines
• Strong oral and written communication and interpersonal skills; works well in teams and independently
• Willingness and ability to travel to all service locations
• Supports culturally competent, recovery-based, person-centered, and trauma-informed practices

Preferred

• Experience with Medicaid waiver programs, HCBS services, or Intellectual/Developmental Disabilities and/or Autism populations
• Working knowledge of Michigan Medicaid Specialty Behavioral Health Services
• Life experience with diverse racial, ethnic, and cultural backgrounds, including behavioral health issues

WORKING ENVIRONMENT

Office or home environment with frequent sitting, standing, and walking. Occasional travel to CMHSPs or conferences. Occasional lifting up to 20 lbs.