Manager of Medical Frailty

State of Indiana•Indianapolis, IN

7d•Onsite

About The Position

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 healthcare 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. The Manager of Medical Frailty supports the Office of Medicaid Policy and Planning (OMPP) in overseeing the complex classification of Healthy Indiana Plan beneficiaries who qualify for exemptions from Medicaid community engagement requirements. This role bridges clinical teams, IT systems, and legal departments to verify medical frailty using claims data, provider certifications, and health screener. Your role provide statewide clinical oversight of the medically frail identification and verification process. You will ensure that medically frail determinations are individualized, evidence-based, and clinically justified, rather than automatically assigned based on diagnosis alone. The Manager of Medical Frailty will conduct clinical reviews, perform retrospective audits, validate MCO submissions, and ensure that members who qualify for medically frail protections receive appropriate benefits and coverage pathways.

Requirements

Registered Nurse (RN) with experience in Medicaid, managed care, clinical assessment, disability determination, utilization management, or care management.
Strong analytical skills.
Strong clinical judgment.
Familiarity with federal medically frail criteria.
Extensive knowledge of the principles, practices, and techniques of a broad area of training and education, including texts and materials developed in the field.
Thorough knowledge of the agency or institution’s functions, operations, and purpose.
Considerable knowledge of experiential learning techniques.
Practical knowledge of laws, rules, and regulations governing mandated training within the agency.
Ability to develop, monitor and evaluate broad training programs.
Ability to plan and conduct seminars, workshops, and training sessions.
Ability to assemble training materials, including writing comprehensive manuals and assembling texts, films, slides, and characters.
Ability to establish effective and cooperative working relationships with trainees, other instructors, and the entire agency staff.
Effective communication skills.
Ability to keep current on new trends, philosophies, and available materials regarding adult education.
Ability to delegate work, set clear direction, and manage workflow.
Ability to effectively give feedback, provide guidance or corrective action, coach, and develop employee skill sets.

Nice To Haves

A degree is not required. However, at least 12 + years of experience applying the outlined knowledge, skills, and abilities in a similar role may be considered. Completion of relevant education degree(s) may substitute for equivalent years of experience.

Responsibilities

Plan, organize, direct, monitor, and participate in ongoing comprehensive development and implementation of specialized programs and development within the agency.
Determine, analyze, identify and implement long-range objectives and specifying the strategies, KPIs, and actions to achieve them.
Analyze operations to evaluate performance of the specific program or its staff in meeting objectives or to determine areas of potential cost reduction, program improvement, or policy change.
Interpret and explain in-depth and complex policies, rules, regulations, or laws to organizations, government or corporate officials, or individuals.
Develop and implement corrective action plans to solve organizational or departmental problems.
Prepare and present reports for approval, including those for funding or implementation of services to executive leadership.
Develop and oversee program financial or budget activities to fund operations, maximize investments, or increase efficiency.
Develop and monitor program requirements to ensure it meets federal and state policies and grants compliance.
Develop and supervise training of employees and consultants on program requirements and usage.
Develop, coordinator, and deliver communication plans and communications.
Preside over, or serve on, boards of directors, management committees, or other governing boards.
Recruit, select, onboard, and train employees to ensure role responsibilities and expectations are clearly understood while providing opportunities to continue professional development.
Set expectations, measure progress, provide ongoing feedback, and evaluate the performance of employees.
Ensure work adheres to quality standards, deadlines, and proper procedures.

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
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