LTC Reimbursement Manager
About The Position
This role, Long Term Care Reimbursement Manager, oversees reimbursements for the long-term care services as provided through a variety of Medicaid programs including a managed care program for Long-Term Supports and Services (PathWays for Aging), the State Fee for Service program, the Program for All-Inclusive Care for the Elderly (PACE) program and a variety of waiver programs. The Office of Medicaid Policy and Planning (OMPP) is a division within the Family and Social Services Administration, which receives around 18 percent of the state's budget to ensure vital health care coverage to approximately 1 in 4 Hoosiers. OMPP strives to build programs and processes that enable Hoosiers to live in fully engaged communities and reach their greatest emotional, mental, and physical well-being. Our mission is to support individual and community well-being with effective and efficient programs, remarkable collaborations, measurable impact on individuals and communities, and an energized staff that is fully engaged with this mission.
Requirements
- Bachelor's degree in a related field (Accounting, Finance, Health Administration, or similar) with at least 5 years of healthcare experience.
- A minimum of three (3) years of management experience in LTC long-term care financial or operational roles.
- A minimum of two (2) years of staff management and evaluation experience.
- Strong leadership and creative problem-solving skills; must possess excellent verbal and written communication skills and the ability to effectively engage stakeholders including agency leadership, providers and provider associations, regulators, health plan executives and technical support teams.
- Knowledge of federal and state public health care programs and policy, healthcare purchasing, the health insurance industry, and national public health care issues and trends.
- Must be familiar with Medicaid delivery systems and underlying programs.
- Ability to plan, initiate, and properly execute programs and initiatives.
- Must be highly self-motivated, analytically-minded, and possess the ability to manage multiple projects simultaneously.
- Ability to analyze and predict fiscal and operational impacts of any proposed reimbursement adjustments/corrections.
- Ability to anticipate and mitigate potential roadblocks or challenges to program development and success.
- Ability to resolve issues with professionalism and sensitivity; must work well with other agencies, divisions and support agency objectives.
- Proficiency in Microsoft Office Suite (Excel, Word, and PowerPoint).
- Ability to compile, synthesize, and present complex recommendations; and
- Passion for public service.
Nice To Haves
- Familiarity with Indiana Health Coverage Programs (IHCP) and Medciare programs is preferred.
Responsibilities
- Position will provide leadership, day-to-day supervision and development opportunities to the Long-Term Care (LTC) Reimbursment team in the oversight and administration of reimbursment programs for skilled nursing facilites, group homes, PACE, home health care and hospice care.
- Provider reimbursement responsibilites include Medicaid benefit payments as well as Supplemental payment programs that provide enhanced benefit levels.
- Collaborate with OMPP Reimbursement / Financial / Rating Vendors to quanfity the fiscal impact of any LTC reimbursement changes.
- Serve as a subject matter expert for projects involving potential LTC reimbursment changes or for addressing reimbursement concerns being raised by providers or other stakeholders.
- Evaluates and audits Indiana Medicaid LTC reimbursement policies, practices and outcomes, including managed care entities and the State’s Fiscal Agent which is responsible for reimbursement for fee-for-service programs.
- Represents the Agency and Division to external organizations, including but not limited to, providers, provider associations, advisory committees, MCEs, legislators, lobbyists and members in a manner that maintains the integrity of and enhances the reputation of Indiana Health Coverage Programs.
- Provides expertise to assist with policy development and implementation, ensuring proper review and incorporation of State and Federal law.
- Works and coordinates with other OMPP sections to ensure integrity and fidelity to agency mission and vision.
- Assist and own other projects in support of the agency’s mission as assigned by supervisor,division executives, and agency leadership.
Benefits
- Three (3) medical plan options (including RX coverage) as well as vision and dental plans
- Wellness Rewards Program: Complete wellness activities to earn gift card rewards
- Health savings account, which includes bi-weekly state contribution
- Deferred compensation 457(b) account (similar to 401(k) plan) with employer match
- Two (2) fully-funded pension plan options
- A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to: 150 hours of paid New Parent Leave and up to eight weeks of paid Childbirth Recovery Leave for eligible mothers
- Up to 15 hours of paid community service leave
- Combined 180 hours of paid vacation, personal, and sick leave time off
- 12 paid holidays, 14 on election years
- Education Reimbursement Program
- Group life insurance
- Referral Bonus program
- Employee assistance program that allows for covered behavioral health visits
- Qualified employer for the Public Service Loan Forgiveness Program
- Free Parking for most positions
- Free LinkedIn Learning access
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What This Job Offers
Job Type
Full-time
Career Level
Manager
