EPSDT/Compliance Administrator (Albuquerque, NM)

24 Hour Home Care - Corporate Division•Albuquerque, NM

1d•$21 - $22

About The Position

Are you looking for a rewarding career where you can make a difference in people's lives? The EPSDT/Compliance Administrator is a leadership and operational role responsible for the administration, compliance oversight, and coordination of Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Personal Care Services (PCS) in accordance with New Mexico Medicaid (Turquoise Care) requirements. This position ensures compliance with New Mexico Human Services Department (HSD), Medical Assistance Division (MAD), and Healthcare Authority (HCA) regulations.

Requirements

High school diploma or equivalent; Associate’s or bachelor’s degree in healthcare administration or related field preferred.
Experience with NM Medicaid/EPSDT or PCS services preferred.
Proficiency in MS Office (Word, Excel, PowerPoint) and other relevant software
Strong knowledge of compliance, audits, and healthcare operations.
EMR/LMS software experience preferred
Strong communication skills, both written and verbal
Excellent organizational skills and attention to detail
Ability to multitask and prioritize tasks effectively
A friendly disposition and ability to work well with diverse groups of people
Bilingual (English/Spanish) preferred
Current CPR certification is required for this position and must be maintained throughout employment in accordance with agency policy, New Mexico Healthcare Authority (HCA), and Medicaid/EPSDT requirements.
Must be able to talk, listen, and speak clearly on the telephone.
While performing the duties of the job, employee is required to stand, walk, stoop, bend, sit for long periods of time; and must be able to read, write, speak, and hear well enough to communicate. Manual dexterity is required to utilize keyboards and office equipment. Employee may occasionally be required to lift up to 20lbs to file documents, and/or store office material. Reasonable accommodation will be made to accommodate individuals with disabilities that can perform essential job functions.
Push and pull 50 pounds (move equipment, etc.)
Carry equipment/supplies
Use upper body strength
Squeeze with hands (operate fire extinguisher)
Twist
Bend
Stoop/squat
Move quickly (respond to emergencies)
Climb stairs
Walk
Stand

Responsibilities

Manage EPSDT referral intake, tracking, and service initiation.
Coordinate new member onboarding, ensuring eligibility verification, service authorizations, and required RN assessments.
Schedule and maintain RN supervisory and reassessment visits per NM EPSDT timelines.
Maintain accurate EPSDT member records in compliance with MAD and DOH standards.
Develop and maintain compliance policies, procedures, and work instructions aligned with NM Medicaid regulations.
Ensure compliance with DOH, HCA/MAD, and federal Medicaid requirements.
Conduct internal compliance audits and maintain audit readiness.
Interpret NM Administrative Code (NMAC) and Turquoise Care EPSDT policies.
Monitor regulatory updates and implement required operational changes.
Onboard Personal Care Assistants (PCAs).
Maintain PCA schedules to meet authorized service plans.
Conduct PCA trainings, evaluations, and competency validations.
Validate timesheets/mileage and maintain personnel records for EPSDT PRN RN’s
Ensure timely renewals and compliance for all employees.
Receive, document, and investigate all incidents.
Conduct internal investigations and corrective action plans.
Report findings to the VPO and CEO.
Educate staff on EPSDT policies, compliance, and NM regulatory requirements.
Maintain documentation of all required trainings.
Maintain accurate compliance, personnel, and EPSDT records.
Produce internal and external reports as required.
Assist with marketing initiatives and community outreach.