Medicaid Contract Supervisor-161994

What Success Looks Like In This Job

This position supervises Medicaid Contract Specialists who determine Medicaid eligibility for applicants / participants.

• This position will direct, plan, motivate, and organize all unit staff members in correctly applying the County, State, and Federal rules, regulations, and procedures;
• conduct day-to-day oversight of the Medicaid Contracts Team (MCT) who work at various locations such as health clinics, schools, and hospitals;
• monitor caseloads and unit performance, performs research, and oversees accurate and timely processing of program rules and regulations;

serve as Departmental representative and focal point for Medicaid contracts; and ensure county's Medicaid agreements with partner agencies and other counties are fully met by all parties.

This position works closely with various internal and external stakeholders to create, maintain, and terminate contracts with various organizations, along with managing the team member positions associated with each Medicaid contract.

Examples of Duties for Success

• Substantial and continuous interaction with each contract representee to discuss contract obligations, requirements, personnel concerns, yearly costs, etc.
• Collaborates with various internal stakeholders regarding Medicaid contracts, including Budget, Finance, County Attorney's Office, and the Board of County Commissioners (BoCC).
• Collaborate extensively with the Finance team to discuss and analyze employee and administrative costs a cost analysis.
• Prepare, write, offer, and resolve all cost amendments and legal contracts for each contract entity, including partnering with Finance to determine monthly contractor costs, writing contracts, collaborating with the County Attorney’s Office for contract approvals, collaborating with Budget on contract approvals, requesting approval and consent at a BoCC hearing, updating contracts based on BoCC determinations, and finalizing resolutions with the County Attorney’s Office and each contract representee.
• Supervises and monitors daily operations of the unit in regard to caseloads, schedules, appointments, deadlines, and other unit issues.
• Reviews workflow regularly in order to meet unit, section, and division short term and long-term goals, and ensures compliance with contractual agreements related to cases processed.
• Sets priorities, initiates changes, and balances demands for meeting deadlines.
• Monitors and analyzes workflow and makes adjustments to assignments to ensure efficiency of the unit.
• Functions as a technical expert on program requirements and procedures and provides assistance to staff on difficult and complex technical problems.
• Functions as a technical expert on Medicaid contracts and all processes related to creating, maintaining, adjusting, and terminating contracts.
• Provides guidance and training to staff, assists with research and correct application of program rules, applies an understanding of CBMS and other computer systems, and provides feedback to management.
• Provides individual or group training on caseload procedures, organization, and maintenance.
• Participates in monthly internal and external meetings.
• Monitors CBMS, case records, and other pertinent paperwork to ensure compliance with rules and regulations.
• Meets regularly with staff in unit meeting and meets individually with each staff member to disseminate department information, notify staff of programmatic and procedural changes, and to provide feedback regarding performance.
• Makes recommendations to section manager for staffing, equipment, and staff development needs.
• Establishes staff performance standards, completes performance evaluations, addresses performance issues, works with management to implement disciplinary action when appropriate, and participates in the selection process for employees in the assigned unit.
• Develops and updates unit schedules.
• Addresses and rectifies any complaints, procedural problems, or unit problems and develops unit procedures as needed.
• Shares information with relevant stakeholders and makes appropriate customer referrals.
• Compiles unit reports for manager, identifying unit accomplishments, concerns, and priorities.
• Makes recommendations for adjustments to business procedures based upon staff efficiency, timeliness, and statistical reports.
• Uses internal systems, CBMS, and other available reports to identify and resolve areas of concern.
• Participates in unit meetings, State, and County sponsored trainings, monthly CBMS trainings, and other activities as required to improve and enhance job performance.
• Participates with State departments and HCPF in decisions related to State and Federal rules pertaining to training, processes, etc.
• Assists with the training of staff. Provides coverage for other supervisors within section, section manager, and technical positions within section.
• Attends hearing and disputes resolutions as needed.
• Assists in the hiring process for all new employees.
• Performs other related duties and responsibilities as required.

Qualifications for Success

• Ability to work collaboratively with various programs within and outside of the department.
• Technical writing skills to aid in completion of contracts and document to be submitted to the Board of County Commissioners.
• Knows all aspects of contract management including taking an initial idea to a fully approved contract; and contract monitoring.
• Knowledge of basic and effective communication techniques, including interviewing techniques.
• Knowledge of eligibility rules and regulations for programs administered; ability to apply basic math and reading; ability to interpret and apply regulations.
• Knowledge of principles and practices of supervision, adult learning, and training.
• Ability to work with persons in crisis situations and in a high volume; adaptable to a changing environment.
• Ability to operate standard office equipment including telephones, fax machine, scanner, personal computers, printers, etc.
• Computer Skills : Proficiency with MS Office Products, including but not limited to : Outlook, Word, and Excel; knowledge of or the ability to learn agency specific computer software systems, including Assure and CBMS.
• Communicates clearly and concisely, both orally and in writing.
• Ability to establish, maintain, and foster positive and harmonious working relationships with those contacted in the course of work.

More Qualifications for Success

Experience : Five (5) years of contractual, technical and / or supervisory experience.Familiarity with Medicaid programs is strongly preferred.

Familiarity with Contract management is preferred.

• Education and Training : High school diploma or GED equivalent required.An Associate's or Bachelor's Degree is strongly preferred and may substitute for two (2) years of the required experience.
• License or Certificate : None
• Background Check : Must pass a criminal background check.

Adams County complies with Colorado’s Job Application Fairness Act ( JAFA ). JAFA prohibits employers from asking individuals to disclose their age, date of birth, or dates of school attendance or graduation on an initial employment application.

However, additional application materials such as certifications and transcripts containing this information may be required for certain positions;

if such additional materials are requested, applicants may redact information that identifies the applicant’s age, date of birth, or dates or attendance or graduation.