Coordinator for Medicaid

Gadsden Independent School District•Anthony, NM

2d•Onsite

About The Position

To coordinate nursing services for students and staff in the Gadsden Independent School District. This role involves coordinating, implementing, and managing the Medicaid School Health Program (MSBS), providing training to staff regarding reimbursable services, assisting with budget planning for the MSBS program, and coordinating outreach services for uninsured and underinsured students. The position also requires ensuring compliance with Federal and State laws for the MSBS program, monitoring and submitting reports, attending required meetings and trainings, and collaborating with community agencies. The Coordinator will also consult with the New Mexico Human Services Department, school administrators, and other health care professionals to establish and revise policies and procedures. Responsibilities include preparing reports, serving on district-wide committees, and acting as a team member. The role also involves budget and resource management, including establishing a committee to assess Medicaid fund usage, monitoring the Medicaid budget for appropriate expenditures, and maintaining records for audits. Additionally, the Coordinator will identify training needs, facilitate training sessions related to the MSBS program, and act as a resource person. For student services, the Coordinator will identify eligible students, monitor billable health services, perform outreach for insurance and services, maintain a database of providers, students, and services, and track provider certifications and licenses. The position requires maintaining student and employee confidentiality and performing other duties as assigned by supervisors. The Coordinator directly supervises the Medicaid Clerk/Secretary/Specialist.

Requirements

Degree in a Related Field
Three years experience related to Medicaid
Computer experience: Microsoft Office (Word, Excel Data Base Management) Outlook
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write reports, business correspondence, and procedure manuals.
Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
Ability to understand documents, define problems and draw valid conclusions.
Interpersonal skills to coordinate and collaborate.
Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.
Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
Must be able to compare, analyze, communicate, coordinate, instruct, synthesize, compute, evaluate, compile, negotiate, deal with problems and manage multiple priorities.
PED mandated background check.

Responsibilities

Coordinate, implement, and manage the Medicaid School Health Program (MSBS).
Provide training to all nursing, special education staff, and others as required regarding reimbursable services.
Assist the Director of Nursing and Health Services with the budget planning and utilization of funds that are generated annually through the MSBS program.
Coordinate outreach services for uninsured and under insured students.
Assure compliance with all Federal and State laws and mandates required by the MSBS program.
Ensure district Medicaid documentation complies with all Federal and State laws and mandates required by the MSBS program.
Monitor, prepare and submit District, State and Federal reports related to MSBS.
Attend and participate in all meetings and trainings as required by NMHSD – MSBS.
Works with community agencies as needed to optimize the MSBS.
Consults with the New Mexico Human Services Department Health – Medical Assistance Division School Health Office, school district administrators, and other health care professionals to establish and revise policies, procedures, and programs specific to the Management of Medicaid in the schools.
Prepare written and oral reports for school district administrators and state agencies as requested or required by the NMHSD – MSBS Program.
Serve on district wide committees as required.
Participates as a team member sharing information and resources as appropriate.
Establish and lead a committee to review and assess the use of Medicaid funds in the schools.
Monitor Medicaid budget to ensure Medicaid expenditure is health related and an appropriate use of the funds.
Monitor annual Medicaid in the Schools budget and expenditures, process requisitions, and purchase orders not to exceed prescribed limits.
Maintain all records and documentation as prescribed by the MSBS program and district for review and audit purposes.
Identify training needs for health service providers, district administrators, and educational staff as related to the MSBS.
Facilitate, organize, and/or provide training to school district staff and administrators related to the MSBS Program.
Act as a resource person for the MSBS program.
Identify Medicaid eligible students on a monthly basis.
Monitor billable health services provided by all district health care providers who are qualified health service providers.
Perform outreach activities to assist underinsured and uninsured students with accessing health insurance and services.
Maintain database to track all providers, students, and Medicaid billable health services.
Maintain files and documentation for the MSBS program.
Track certifications and licenses of school health providers and submitted to 3rd party billing agency.
Maintains student and employee confidentiality.
Promote and follow district policies and procedures.
Directly supervise the Medicaid Clerk/Secretary/Specialist to ensure compliance with the district and MSBS guidelines and regulations.