Heritage Health Program Coordinator
About The Position
The Department of Health and Human Services is seeking a motivated individual to join the Medicaid and Long-Term Care team to fill the role of Heritage Health Program Coordinator. The Heritage Health Program Coordinator will work under limited supervision, coordinate the administration of various state and federally funded programs throughout the state to include grant/contract administration, budget monitoring, and the development of program policies, procedures, and evaluation criteria to ensure compliance with state and federal regulations; perform related work as required. This position will monitor, analyze, and coordinate all grievance and appeal functions for one of the Heritage Health contracts. Heritage Health provides Medicaid covered physical health, behavioral health, dental health, and pharmacy services for Nebraska's Medicaid population. The program coordinator will be responsible for ensuring that their plan meets the operational requirements of the contract and complies with federal managed care rules and regulations, which are complex and extensive.
Requirements
- Bachelor's degree in business or public administration, social/behavioral sciences, health sciences, public health, education, law or related field OR experience in the development of operational policies and procedures, performing quality assurance analysis/evaluation of programs; grant writing, contract management, or leading community based health/social care groups.
- Related coursework, training and/or education may substitute for the Bachelor’s degree on a year-for year basis.
- Valid driver's license or the ability to provide independent authorized transportation.
- Regular, predictable attendance is an essential job function.
- Knowledge of business and management principles.
- Knowledge of quality assurance /performance improvement principles and methods of analyzing continuous improvement.
- Skills to communicate clearly and effectively orally or in writing.
- Ability to relate well with a diverse number of individuals or organizations and work with people in a variety of roles (leadership, cooperation, education, and networking).
- Ability to learn, apply, and interpret agency policies and procedures relating to areas of responsibility.
- Ability to identify and relate pertinent pieces of information to form conclusions.
- Ability to respond to changes in direction.
- Ability to establish and maintain a positive working relationship with managers and administrators.
Nice To Haves
- Experience in Medicaid and healthcare practice standards for either government or commercial plans.
- Experience and knowledge in program planning, implementation, monitoring, evaluating program functions.
- Advanced proficiency in Microsoft SharePoint, Excel, Outlook, Word, and PowerPoint.
Responsibilities
- Act as a liaison and confer with various federal and state authorities, health plan staff (including Director of Grievance and Appeals), policy review staff, care management staff, and community leaders.
- Review and prepare written oral summaries on state and federal legislation.
- Provide analysis of Grievance and Appeals data and quality metrics.
- Coordinate the development of program goals and evaluation criteria with agency staff, health plans staff, community officials, and/or other state government staff.
- Participate in public hearings on proposed policy revisions.
- Develop corrective action plans for program deficiencies.
- Serve on relative community organizations, committees, task forces, and advisory boards.
Benefits
- comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
