Administrator for Medical Services

State of careers Rhode Island

7d • $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 ensuring compliance with federal and state regulations, managing staff, developing program policies, and overseeing budget development. The administrator will also be involved in public relations, legislative impact analysis, and staff recruitment and training.

Requirements

• 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, including development and implementation of rules, regulations, procedures, and fee and cost standards.
• 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 to explain program philosophy, objectives, and operations, and to provide consultative services.
• Ability to collect information relative to a medical care program and prepare 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.
• Graduation from a college of recognized standing and possession of a Master's Degree from an accredited institution of higher education in 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 is substantially equivalent to the above education and experience.
• Must undergo a national fingerprint background screening.
• Must have employment eligibility validated through E-Verify.

Nice To Haves

• Experience in evaluation strategy development and framework validation.
• Experience in overarching evaluation plan design and vetting.
• Experience in initiative and project-specific evaluation and quality improvement cycles.
• Experience in performance measurement, including performance management and CMS-required metrics reporting.
• Experience in qualitative data assessment and community feedback validation.
• Experience in data sharing requests, coordination, and parameter development.
• Experience in oversight of evaluation supports and consultants.
• Experience in interagency coordination of evaluation, epidemiology, health economics, and data analytics councils.
• Experience in CMS and other related dashboard creation and reporting.

Responsibilities

• Assist the Associate Director for Medical Services in the development and revision of rules, regulations, procedures, and fee and cost standards governing the procurement and payment of medical services and supplies.
• Conduct conferences with appropriate professional groups and other state medical and dental services to ensure common understanding, reconcile discrepancies, and address violations of rules and regulations.
• Prepare manuals based on rules, regulations, procedures, and fee cost standards for medical and dental service providers.
• Plan, supervise, and review the work of a professional staff and oversee the responsibilities of a clerical staff.
• Participate in program analysis and evaluation.
• Assist the Associate Director for Medical Services in community activities related to medical care and health planning.
• Collect statistical data on the medical care program and prepare reports on trends.
• Coordinate activities between 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 to ensure qualification for federal matching funds.
• Liaise with federal officials from the Department of Human Services, including program, audit, and fiscal staff.
• Respond to inquiries from the news media, participate in local television programs, and speak to community groups.
• Assist the Associate Director for Medical Services in developing the annual budget for the Medical Assistance Program and participate in relevant hearings.
• Understand and ensure compliance with state statutes and assist in developing position statements on impacting 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 other special reports.
• Manage a public relations and information program, including speaking engagements, community committees, legislative committees, and meetings with consumer groups.
• Analyze the impact of new federal and state legislation on the Medical Assistance Program.
• Recruit and train staff personnel.
• Serve as the Rural Health Transformation Program (RHTP) Evaluation Lead, including strategy development, plan design, initiative-specific evaluation, performance measurement, data collection and analysis, qualitative data assessment, data sharing coordination, oversight of evaluation supports, interagency coordination, and dashboard creation.

Benefits

• Information regarding benefits available to State of Rhode Island employees can be found on the Office of Employee Benefits' website.
• Direct deposit for all employees is required for new hires after September 30, 2014.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager