Medicaid Operational Support Team Representative

State of North Carolina

1d•Remote

About The Position

The purpose of the OST Representative is to provide oversight of county administration of the Medicaid programs that provide services for all families served at the county level through the NC FAST system and to ensure that all benefits are issued in a timely, accurate, and efficient manner. Most of the necessary functions are carried out in visits to the County Departments of Social Services, individual conferences with Income Maintenance Program Managers and Supervisors and County DSS Directors or in group meetings. There is also contact with applicants and recipients, with sister agencies and with specific program service providers. The OST Representative has onsite system support and guidance on the NC FAST case management system to staff within the Department of Health and Human Services and to county departments of social services staff statewide. Employee must have or be willing to receive NC FAST training in order to provide assistance to new NC FAST users in system navigation, troubleshooting individual cases, and analyzing problems encountered by users as they learn to successfully use NC FAST to complete the work of determining eligibility for economic benefit programs. Assistance may be provided to staff at all levels of agencies that oversee and administer Medicaid programs through the NC FAST system. This position may also be called upon to assist with Help Desk support and/or support classroom training activities. Duties include communicating with and engaging staff, assisting with development of strategies to reinforce practical application of new skills for navigating and successfully working in NC FAST, assessing readiness and proficiency of users, and communicating with project staff to enact plans for achieving proficiency in using the NC FAST system. Duties also include tracking progress and measuring increased success by users. This position may analyze trends in user issues that may indicate gaps in training needs and provides feedback on areas where new users have the greatest difficulty to ensure end user comprehension and overall continuous improvement.

Requirements

Master's degree in a discipline relative to the program from an appropriately accredited institution and four years of related experience; or Bachelor’s degree in a discipline relative to the program area from an appropriately accredited institution and six years of related experience; or an equivalent combination of education and experience.
Willingness to receive NC FAST training.

Nice To Haves

Comprehensive knowledge of management principles, resource allocation, supervisory practices, and coaching techniques to effectively support and guide county Medicaid operations.
Strong understanding of Medicaid program structure, financing, policies, and regulations, with the ability to advise counties on effective program management strategies.
Skilled in mediation and conflict resolution, utilizing arbitration techniques to address issues between county departments and external agencies.
High level of accuracy, attention to detail, and concentration in managing work that directly impacts Medicaid applicants and recipients.
Effective communication and training abilities, including knowledge of adult learning principles, with the capacity to plan, organize, and lead meetings and deliver clear verbal and written guidance to diverse audiences.

Responsibilities

Serve as a management consultant to DSS supervisors and directors, identifying program needs and advising on management decisions, organizational structure, staff allocation, and personnel classification requirements.
Advise counties on problem-solving, prioritizing work, and restructuring work assignments, especially when additional staff is unavailable.
Provide guidance on dealing with poor employee performance.
Participate in planning for the impact of changing community needs and program growth, such as implementing policies that expand coverage.
Conduct joint meetings with staff across programs to promote better internal communication.
Teach and reinforce supervisory skills through individual consultation, cluster meetings, or formal training presentations.
Ensure county staff correctly understand and apply all programs’ manual policy, including reviewing and enhancing policy in draft stage, interpreting new policy, and conducting remedial training.
Review Administrative Letters, directives, and memos with county staff to ensure proper handling of all program facets.
Review NC FAST system procedures and functions to ensure proper and timely data entry and report usage.
Analyze reports to identify problems and areas of concern, and develop corrective action plans with the county, including training and internal procedural changes.
Monitor and evaluate corrective action plans and provide feedback to the county regarding performance.
Identify, coordinate, and deliver needed training in policy, NC FAST procedures, supervisory skills, resource management, customer service, and interviewing skills.
Evaluate training needs, develop training materials, present training, and evaluate training effectiveness.
Monitor county performance monthly to ensure compliance with application and recertification processing standards and federal processing time standards, and assure corrective action is taken as needed.
Provide valuable information for state-level planning regarding policy misunderstandings or county barriers to implementation.
Make presentations to County DSS Boards and County Commissioners on program needs and mandates.
Work with service providers to resolve communication problems between the provider and the county department of social services.
Study policy material and update reference books monthly.
Complete written material including county visit and activity reports, activity summaries, letters to directors of social services departments, and other correspondence.
Meet with representatives for other programs.
Assist with resolving Medicaid Help Center tickets in Service Now for Medicaid beneficiaries/members who have a disruption of services.
Provide onsite system support and guidance on the NC FAST case management system to staff within the Department of Health and Human Services and to county departments of social services staff statewide.
Provide assistance to new NC FAST users in system navigation, troubleshooting individual cases, and analyzing problems encountered by users.
Communicate with and engage staff, assist with development of strategies to reinforce practical application of new skills for navigating and successfully working in NC FAST.
Assess readiness and proficiency of users and communicate with project staff to enact plans for achieving proficiency in using the NC FAST system.
Track progress and measure increased success by users.
Analyze trends in user issues that may indicate gaps in training needs and provide feedback on areas where new users have the greatest difficulty.