ADMINISTRATOR FOR MEDICAL SERV

State of careers Rhode Island

4d•$115,008 - $133,541•Onsite

About The Position

This position assists the Associate Director for Medical Services in the planning, development, supervision, coordination, and administration of a statewide medical care program for eligible recipients of medical assistance. The role involves developing and revising rules, regulations, and standards for medical services, conferring with professional groups, preparing manuals, and supervising staff. The Administrator also participates in program analysis, evaluation, community activities, and data collection for reporting trends. Coordination with the Data Processing Unit for program changes and compliance with federal regulations is crucial. The position assists in developing departmental policy and a state plan for the Medical Assistance Program to ensure continued federal matching funds. It involves communication with federal officials, responding to media inquiries, and participating in public forums. Budget development, legislative impact analysis, and participation in collective bargaining and contract negotiations are also key responsibilities. The role includes managing public relations, recruiting and training staff, and ensuring compliance with state statutes and federal regulations.

Requirements

Graduation from a college of recognized standing and possession of a Master's Degree from an accredited institution of higher education in the field of Medical Care Administration, Public Administration, Social Work, Public Health Administration or Business Administration.
Employment as a Chief Medical Care Specialist; or employment in a responsible supervisory position in the field of public health, medical care administration or social work.
Any combination of education and experience that shall be substantially equivalent to the above education and experience.
Thorough knowledge of approved principles and practices of health care financing administration.
Ability to apply knowledge in planning and administration of a statewide medical care program.
Familiarity with the practices and procedures of hospitals, nursing homes and other institutions providing medical care and treatment.
Ability to relate to members of the medical and dental professions, social service staff and other interested parties.
Ability to collect information relative to a medical care program and prepare various trend data for statistical purposes.
Ability to plan, supervise and review the work of a professional, technical, fiscal and clerical staff.
Ability to establish and maintain effective working relationships with professional groups, consumer groups, the community, the legislature and other public and private agencies.
Must undergo a national fingerprint background screening.
Must have employment eligibility validated through E-Verify.

Nice To Haves

Experience in the development and implementation of rules, regulations, procedures, and fee and cost standards governing the procurement and payment of medical services and supplies.
Experience in providing consultative services and advice as required.
Experience in strategic planning, risk assessment, task execution, performance tracking, team development, and driving innovation.
Experience in managing budgets and contracts.
Experience in coordinating CCBHC implementation and resources across agencies.
Experience in communicating with stakeholders to ensure efficient and effective execution of work.
Experience in developing a high-performance, collaborative team culture.

Responsibilities

Assist the Associate Director for Medical Services in the planning, development, supervision, coordination, and administration of a statewide medical care program.
Develop and revise rules, regulations, procedures, and fee and cost standards governing the procurement and payment of medical services and supplies.
Confer with appropriate professional groups and other state medical and dental services to ensure common understanding, reconcile discrepancies, and address violations.
Prepare manuals based on rules, regulations, procedures, and fee cost standards for medical, dental, and other service providers.
Plan, supervise, and review the work of a professional staff and oversee the activities of a clerical staff.
Participate in program analysis and evaluation.
Assist in community activities related to medical care and health planning.
Collect statistical data relative to the medical care program and prepare reports on trends.
Coordinate activities of the Medical Assistance Program staff and the Data Processing Unit for programming changes and compliance with federal regulations.
Assist in the development of departmental policy and a state plan for the Medical Assistance Program.
Relate to federal officials of the Department of Human Services, including program, audit, and fiscal staff.
Respond to inquiries from the news media, participate in television programs, and speak to community groups.
Assist in the development of the annual budget for the Medical Assistance Program and participate in relevant hearings.
Understand and ensure compliance with appropriate state statutes and assist in developing position statements on legislation.
Participate in collective bargaining and contract negotiations, and enforce contractual agreements.
Assist in the preparation of the annual report for the Rhode Island Medical Assistance Program and special reports.
Be responsible for a public relations and information program, including speaking engagements and community/legislative committee participation.
Analyze the impact of new federal and state legislation on the Medical Assistance Program.
Be responsible for recruiting and training staff personnel.
Provide statewide leadership for Rhode Island’s CCBHC project, ensuring effective planning, implementation, and compliance.
Oversee budget development, fiscal integrity, and contract administration for the CCBHC program.
Direct the development of systems, reporting, and analytics for the CCBHC project.
Represent the CCBHC project in state and national forums.
Staff the CCBHC Leadership Team for interagency program oversight.
Maintain compliance with federal and state laws, Demonstration requirements, and internal policies for the CCBHC project.
Lead risk management and continuous oversight activities for the CCBHC project.
Coordinate with federal partners as a SAMHSA selected CCBHC Demonstration State.
Perform fiscal reporting to appropriate state and federal offices for the CCBHC project.
Provide day-to-day oversight and leadership on the development of CCBHC Program Components (Provider Certification, Rate Setting, Billing, Clinical Oversight, Quality Reporting).
Coordinate provider meetings and engagement activities.
Directly supervise CCBHC staff at EOHHS and provide leadership to the interagency team.
Develop an ongoing evaluation and data strategy, including dashboards and reporting for the CCBHC project.
Coordinate data-informed roundtables with State, CCBHCs, and MCOs for program monitoring and improvement.