Program Representative (766672)

Minimum Qualifications

MINIMUM EXPERIENCE AND TRAINING:

• A bachelor's degree in psychology, social work, human services, public health, or public administration or other related field.
• A minimum of one (1) year experience working in a public or private human service program with administrative experience such as case management, service delivery, data collection, or program monitoring/quality assurance experience is preferred. Experience using HCSIS is preferred.
• Excellent organizational skills.
• Ability to work independently and with minimal supervision.
• Ability to communicate effectively orally and in writing, including computer-based communication using email, word processing and data base systems. Ability to develop PowerPoint presentations and speak in public forums.
• Ability to evaluate and prioritize a variety of competing demands and deadlines. Ability to work with a variety of individuals in teams, both as a leader and as a participant, who are geographically dispersed.
• Intermediate Computer skills to include, but not limited, to Microsoft Office Products.

Role Description:

Job Duties

• The employee is part of the Southeast Bureau of Community Services (BCS) and will be supervised by Mary Citko.
• The employee in this position performs coordination and administration work for the Bureau of Community Services to ensure compliance with Federal and State regulations, policies and procedures, and understanding of the goals and initiatives of ODP.
• Evaluates and assesses the quality of community programs, services, and supports through on-site visits and the review of records to assure that individual’s needs are identified and met through the QA&I review process and/or ad hoc monitoring as needed
• Ensures fidelity to Supports Intensity Scale (SIS) protocols. Supports the discrepancy review process.
• Monitor compliance with EPSDT requirements for Medicaid-eligible individuals under 21. Collaborate with Managed Care Organizations (MCOs), providers, Administrative Entities and other stakeholders to resolve EPSDT issues and promote transition to adult services.
• Review and analyze IM4Q data for trends and systemic concerns. Support stakeholder engagement and communication and training related to IM4Q.
• Participate in and support Provider Applicant Orientation (PAO). Review provider applicant materials, monitor timelines and maintain accurate records of provider applicant statuses and inquiries. Provide technical assistance to provider applicants, providers and Administrative Entities (AEs).
• Respond to inquires and concerns from individuals, families, providers and other stakeholders. Document and track issues to ensure timely resolution. Provide policy clarification and referrals to appropriate ODP resources.
• Coordinates and collaborates with service coordinators, providers, participants, family members, other departments, and advocacy groups through on-site visits, training, conferences, and team meetings.
• Assists Mary Citko with managing Information Technology (IT) projects including work involving HCSIS, PROMISe, and the future Enterprise Case Management (ECM) system. Responsibilities include but are not limited to, providing technical assistance, participation in meetings regarding design and implementation of new functions, review documents, testing prior to implementation, troubleshooting, providing and participating in training to the field, and provide feedback as required or in other areas as required.
• Collaborates with other DHS offices, other non-DHS offices, legislative offices, and community organizations to communicate the philosophy and initiatives of the Bureau of Community Services.
• Responsible for oversight of program activities, plan reviews and approvals, administration, and analysis of the BCS Intellectual and Developmental Disabilities and Autism (ID/A) program, including on-site reviews, data collection and investigations, monitoring for compliance of both state and federal policies and procedures and preparing reports of the findings.
• Directs and/or participates in the development, coordination, implementation and validation of corrective action plans to address any problems identified through annual and ongoing monitoring.
• Applies sound principles in collecting information/data, both routinely and on an ad hoc basis, and interprets and analyzes information to assess compliance with contractual, regulatory, and departmental standards.
• Assures accurate maintenance of statistical data needed to prepare periodic internal and annual CMS reports.
• Provides assistance to providers regarding rates and billing.
• Represents ODP at meetings, conferences, including committees, work groups, certain advisory boards and councils, and advocacy organizations. Accurately assesses and report community and participant concerns and interests to ODP.
• Responds to inquiries both in writing and verbally.
• Perform other duties as assigned.

About Us:

TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.

TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com