Medicaid and Funding Manager

Delaware, County of • Delaware, OH

1d

About The Position

The Medicaid and Funding Manager serves as the agency’s Medicaid Manager and provides leadership and oversight of Medicaid waiver and local funding operations. The role ensures accurate and compliant waiver administration, fiscal analysis, payment authorizations, and funding utilization, while supervising assigned funding staff. The position collaborates with internal departments, providers, and external partners to support effective service delivery, regulatory compliance, and sound fiscal stewardship for individuals served by the Board.

The Manager supervises, directs, and evaluates Assessment Specialists and Funding Specialists as assigned. The role provides technical assistance and guidance on waiver fiscal functions, payment authorizations, billing, revisions, initial enrollments, and redeterminations; manages waiver allocations and funding utilization; oversees authorization entries, invoices, and fiscal assignments; and contributes to agency policies, budgets, forecasts, reports, hearings, reviews, and audits. The position must adhere to applicable federal, state, and agency rules and procedures and perform other related duties and projects as assigned.

DCBDD’s mission is to inspire, empower, and support people to achieve their full potential, with a vision that all people will lead personally fulfilling lives. Candidates are expected to model the organization’s core values of Inclusion, Equity, and Integrity.

Requirements

• Bachelor’s degree in a related field and five years of experience with Medicaid Waiver services, or an equivalent combination of experience and education sufficient to perform the essential job functions and provide the required knowledge and abilities.
• Service and Support Administration Supervisor Certification under OAC 5123-5-02, or ability to obtain it at appointment and maintain it throughout employment.
• Valid State of Ohio Driver’s License and an acceptable driving record under the Board’s insurance carrier requirements.
• Successful completion of criminal records and registry/database checks required by DODD, driving record checks, and favorable reference reports from DCBDD.
• Ability to perform sedentary work, including occasional lifting of up to 10 pounds, manual dexterity, talking, hearing, reaching, and navigating the work environment.
• Ability to operate standard office equipment, including a copy machine, fax machine, personal computer, and telephone.
• Model the organization’s core values of Inclusion, Equity, and Integrity.

Nice To Haves

• Master’s degree in a related field and three years of supervisory experience preferred.
• Service and Support Administration Supervisor Certification under OAC 5123-5-02 is preferred, or the ability to obtain and maintain it.

Responsibilities

• Serve as the agency Medicaid Manager and perform Medicaid management functions, including waiver projections, match calculations, analysis, and reconciliation.
• Supervise, direct, and evaluate assigned Assessment Specialists and Funding Specialists, and recommend corrective or disciplinary action when necessary.
• Liaise with SSA Supervisors, Service & Support Administrators, and providers regarding PAWS, billing, revisions, initial enrollments, redeterminations, and complex waiver fiscal issues.
• Maintain knowledge of Ohio Administrative Code, Ohio Revised Code, and waiver amendments related to waiver administration.
• Research payment status for waiver services, obtain additional information, and correct or coordinate correction of errors.
• Serve as liaison to Delaware County Job and Family Services regarding waiver-related eligibility functions and communicate issues to Directors and SSA Supervisors as appropriate.
• Provide technical assistance for payment authorization activities.
• Manage waiver allocations in collaboration with designated agency leaders.
• Prepare for and participate in hearings involving DCBDD decisions regarding waiver services.
• Coordinate and process claims for Medicaid Administrative Claims (MAC), Targeted Case Management (TCM), Title XX, the Rental Assistance Program, and other assigned revenue sources.
• Provide fiscal analysis and reports to the Superintendent as requested.
• Oversee PAWS and local funding authorization entries and ensure timely submission of PAWS forms to DODD for processing.
• Monitor service utilization and revise waiver and locally funded budgets by comparing actual billing with authorized services; recoup unused funds when applicable.
• Ensure budgets are accurately prepared and implemented, authorizations are timely and accurate, providers are properly paid, and requests for service increases are warranted.
• Oversee timely and accurate payment of invoices and other fiscal assignments.
• Assist with developing policies and procedures for operations, Medicaid management, PAWS, the Monthly Rate Calculator (MRC), and local funding authorizations; implement procedures and manage workflow in support of DCBDD goals.
• Administer Medicaid and waiver-related services.
• Participate in DODD and Auditor of State reviews and audits and assist with plans of correction as assigned.
• Assist the Senior Director of Operations and Finance with the annual agency budget, annual cost report, five-year fiscal forecast, and other assigned reports.
• Act as the Senior Director of Operations and Finance’s designee for departmental operational needs when assigned.
• Maintain regular attendance, follow applicable laws and policies, and perform other related duties and special projects as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager