Medicaid Account Manager CONTRACT LENGTH:
12M DATE: 12/18/2013 DATE OF LAST REVISION: 12/18/2013 JOB CODE: FA0425 PAY GRADE: 28 FLSA EXEMPTION STATUS: E Job Family Finance & Accounting JOB SUMMARY
Manages, plans, and organizes the Medicaid compliance unit. Establishes operating policies and procedures for the department.
Oversees the day to day support for the HISD and client districts' Medicaid, IDEA, and IEP/ARD compliance and regulations. Monitors and reviews data to ensure compliance of the HHSC, CMS, TEA, and Medicaid policies. Assesses and mitigates risk.
Monitors and reviews special education documentation included, but not limited to, special education student enrollment, attendance, ARD's scheduling, and grading documentation. Establishes operating policies and procedures for the department. MAJOR DUTIES & RESPONSIBILITIES
List most important duties first 1. Manage, Coordinates, Monitors and reviews special education data through the student information management system and the special education system to ensure IEP/ARD is in compliance for Medicaid program for HISD schools and Client Districts. 2.
Markets and develops new business and provides district Medicaid Finance Consulting services to client school districts. Travels 65% to HISD campuses and throughout the state of Texas to client school districts to conduct desk reviews and/or audits to ensure compliances with school-based medicaid programs policies, procedures and guidelines. Conducts IEP and e-SHARS training for the districts Medicaid providers and communicates ways to improve current practices.
Investigates anomalies and complies with timelines. 3. Develops proposals for client school districts outlining proposed project structures, approaches, and work plans. Negotiates and implements inter-local contractual agreements between the district and client school districts.
Develops operating plans and procedures for client school districts, outlining specific project structure, tactical approaches and detailed working plans to start-up and establish operational capacity to ensure compliance with school based Medicaid programs. 4. Monitors compliance with changing federal and state Medicaid laws. Provides access to applicable documentation and records required by federal and state rules and regulations, and guidelines for Medicaid or other governmental compliance.
Administers and coordinates the full facility services project management of the Medicaid program implementation, client support services, training, and technical support rendered for consultant services. 5. Manages the development and utilization of the management control and tracking systems, including system control programs, and management reporting for each client school district by following quality control standards and maximizing reimbursement revenue. 6. Manage, prepare and coodinate the staff for performing HISD and client-to-standards reviews and audits to maintain continuation of revenue generating reimbursement programs that meet Medicaid compliance requirements. 7.
Performs other job-related duties as assigned. EDUCATION
Master's Degree WORK EXPERIENCE
7+ years TYPE OF SKILL AND/OR REQUIRED LICENSING/CERTIFICATION
PeopleSoft preferred, SAP preferred, Microsoft Office, Chancery preferred,
Office equipment (e.g., computer, copier) LEADERSHIP RESPONSIBILITIES
Management- Manages and accomplishes the majority of work objectives through the management of direct reports. Provides day-to-day direction to staff; may become directly involved, as required, to meet schedules and resolve problems.
Responsible for assigning work, meeting completion dates, interpreting and ensuring application of policies and procedures. Receives assignments in the form of objectives, with goals and the process by which to meet goals. Provides input to hiring, performance and budget. WORK COMPLEXITY/INDEPENDENT JUDGMENT
Work is non-standardized and widely varied, involving many complex and significant variables including significant time spent planning, evaluating complex solutions and issues, and negotiating outcomes. Strong analytic ability and inductive thinking are frequently required to devise new approaches to situations where previously accepted solutions have proven inadequate.
Position regularly makes recommendations to management on areas of significance to the division. Supervision received typically consists of providing periodic coaching, advice and feedback. Work involves the application of moderately complex procedures and tasks that are quite varied.
Independent judgment is often required to select and apply the most appropriate of available resources. Ongoing supervision is provided on an "as needed" basis.
Participates in a group plan and/or budget development. PROBLEM SOLVING
Decisions are made with greater freedom and discretion, including recommendations that are subject to approval on matters that may affect multiple departments across HISD. Job is frequently expected to recommend new solutions to problems, to improve existing methods/procedures/services and generate new ideas. May also review decisions made by other individuals on more routine matters.
IMPACT OF DECISIONS
Decisions have moderate impact to the facility/department or division, causing increased satisfaction or dissatisfaction; producing efficiencies or delays; promoting or inhibiting personal intellectual or professional development; and/or contributing to financial gain or expense. Errors may be serious, usually not subject to direct verification or check, causing losses such as improper cost calculations, overpayment or improper utilization of labor, materials or equipment.
Effect usually confined to the organization itself and is short term. COMMUNICATION/INTERACTIONS
Negotiate and influence - interprets department strategies and services, resolves conflicts, influences outcomes on matters of significance for the division, conducts final negotiations and coordinates approvals/decision making below the executive level. Interactions are typically with customers and Top Management. CUSTOMER RELATIONSHIPS
Leads others in the resolution of highly sensitive and confidential issues on behalf of the department. Acts as a trusted advisor and becomes involved in the customer's decision making process including presenting alternatives and information and applying persuasion and negotiation skills in the resolution of problems.
Monitors customer service standards. coworkers or subordinates. WORKING/ENVIRONMENTAL CONDITIONS
Work is normally performed in a typical interior work environment which does not subject the employee to any hazardous or unpleasant elements.
Ability to carry and/or lift up to 45 pounds or more.
Houston Independent School District