Medicaid and Long-Term Care Resource Developer

State of Nebraska • Lincoln, NE

1d • Hybrid

About The Position

The State of Nebraska Department of Health and Human Services is seeking a highly organized individual with keen attention to detail to join their team as the Medicaid and Long-Term Care (MLTC) Resource Developer. The MLTC Resource Developer works with several programs within DHHS, including Medicaid Long Term Care, Social Services Aged and Disabled, and Aged and Disabled Waiver program. The DHHS Resource Developer, under general supervision, performs a variety of tasks to include performing various contract monitoring activities and resource development activities; researching, gathering and maintaining information on community placement resources; monitoring provider contracts, reviewing provider billing documents, evaluating provider services, performing on-site audits, sharing findings of investigations and providing recommendations concerning service improvement, contract revision, and/or termination; conducting licensing and home studies; developing related community resources and monitoring provider services such as transportation, support services, skills training, and other home based services; and approving service providers to ensure compliance with minimum standards and evaluating provider services, programs and staff to determine appropriateness of client payments and ensure delivery of contract services.

Requirements

• Post high school coursework/training in social work, sociology, counseling, guidance, psychology, child development or related field and experience in resource development, eligibility determination or contract monitoring within a public service organization.
• OR Bachelor’s degree in any of the fields listed above.
• Valid driver's license or ability to provide independent authorized transportation in order to perform work related travel.
• Knowledge of: the principles and practices of social work; federal and State laws, regulations and guidelines concerning services delivery; the principles of individual and group behavior; the techniques of counseling; community and service organizations.
• Skill in: interviewing to collect and elicit essential information; communicating to receive and relay information; listening to and understanding information received; using a keyboard.
• Ability to: learn and apply the methods and procedures of human services resource development; learn and apply agency policies, procedures, programs and philosophy; protect confidential information; interact with community leaders; apply problem solving techniques to a variety of different circumstances; assess customer needs to provide proper services and financial assistance; manage multiple files and records; collect and maintain data and analyze for trends; prepare written case histories and reports.

Nice To Haves

• Good communication skills both written and verbally.
• Experience working with diverse backgrounds and socio-economic levels.
• Experience engaging with providers to establish a working relationship.
• Experience in learning and applying the methods and procedures of human services resource development.
• Understand the importance of protecting confidential information.
• Apply problem solving techniques to a variety of different circumstances.
• Experience working with Policy regulations and guidelines concerning service delivery in programs RD contracts including SSAD, MLTC, and/or AD Waiver.
• Experience managing multiple cases in a fast-paced environment as well as managing multiple files and records.
• Experience working with NFOCUS, Word, Excel, and On-Base.
• Ability to work independently from others.

Responsibilities

• Perform various contract monitoring activities and resource development activities.
• Research, gather and maintain information on community placement resources.
• Monitor provider contracts.
• Review provider billing documents.
• Evaluate provider services.
• Perform on-site audits.
• Share findings of investigations and provide recommendations concerning service improvement, contract revision, and/or termination.
• Conduct licensing and home studies.
• Develop related community resources and monitor provider services such as transportation, support services, skills training, and other home based services.
• Approve service providers to ensure compliance with minimum standards and evaluate provider services, programs and staff to determine appropriateness of client payments and ensure delivery of contract services.
• Enroll independent providers to assist customers with services needed, such as transportation, respite services, chore services, and basic household tasks.
• Facilitate complaint resolution.
• Train and monitor contracted providers for various home and community-based programs.
• Do on-site assessments.

Benefits

• We offer a comprehensive package of pay, benefits, paid time off, retirement and professional development opportunities to help you get the most out of your career and life.
• Your paycheck is just part of your total compensation.
• Check out all that the State of Nebraska has to offer!
• Benefit eligibility may vary by position, agency and employment status.
• For more information on benefits, please visit: https://statejobs.nebraska.gov/index.html#benefits

What This Job Offers

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