This position is deemed 100% Remote Work. This position is a pacesetter in the field who has a unique level of technical expertise in creating the landscape for the creation of interagency collaboration with Health Care Policy and Financing (HCPF) and related billing experts, and the design of policies, procedures, and regulations impacting requirements in ABA Clinic settings. Management routinely relies on the essential consultation of this position before deciding essential, wide-ranging, critical program policy or direction to ensure clinic practice complies with required standards. This position implements the Division’s audit process to include sample reviews, technical assistance and training, issuing reports of inspection, issuing fines, authorizing licensure, and recommending adverse action against a facility, agency, or clinic. This includes researching and staying up-to-date on policies, procedures, and requirements related to payment sources, including collaborating with the Office of Children, Aging, and Community Services (OCACS) Medical Team, the HCPF Children’s Habilitation Residential Program (CHRP) team, private insurance companies, Tricare insurance for military families, and other paying entities to best align requirements with regulation and practices when possible. This position determines whether the agencies are operating in compliance with applicable internal guidelines, rules, policies, regulations, and standards. This position identifies and recommends opportunities for improving standards of practice for programs to meet operational expectations. This position is responsible for ongoing collaboration with HCPF and tracking all bills and rules that have the potential to impact the licensed ABA clinics. This position is responsible for collecting information across entities and subject matter experts related to payment and providing support to other Licensing Specialists and other staff within the Division of Child Welfare when it comes to Medicaid, CHRP, and payment within licensed ABA clinics. This position ensures that youth are receiving safe and adequate care and treatment by evaluating the physical plant, treatment planning, staff and care provider qualifications, training, and supervision, as well as financial stability, interviews with youth in care, and required corrective actions. This position is also responsible for handling and safeguarding confidential information regarding youth in care, as well as for specific provider staff background checks.
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Job Type
Full-time
Career Level
Senior