Medicaid Program Advisor - Specialized Services for Children
About The Position
The Bureau of Specialized Services for Children (BSSC) within the Division of Program Development & Management (DPDM) oversees Medicaid program policy for a wide range of children’s services, including: Children’s Health Home Program Voluntary Foster Care Agencies (VFCA) 29‑I Health Facilities Home and Community Based Services (HCBS) Children’s Waiver for children/youth with behavioral health, medically complex conditions, and developmental disabilities The Medicaid Program Advisor 1 will develop subject‑matter expertise in assigned program areas and support policy development, implementation, and oversight. Responsibilities include analyzing program processes, developing and updating provider guidance, and supporting eligibility determinations for the HCBS Children’s Waiver. The role may involve remote interactions with enrollees, families, providers, and community partners.
Requirements
- 8 years of professional experience
Nice To Haves
- Strong interpersonal, critical thinking, and decision‑making skills
- Knowledge of pediatric diagnoses and developmental/medical needs
- Experience with pediatric home health, medical supports, or supplies
- Knowledge of Medicaid programs and services
- Background in social work or experience supporting populations such as:
- Serious Emotional Disturbance (SED)
- Foster Care
- Medically Fragile youth
- Developmental Disabilities
- Substance Use Disorders
- Chronic/complex medical conditions
- Strong time‑management and organizational skills
Responsibilities
- Become knowledgeable in Medicaid children’s programs: Health Homes, HCBS Children’s Waiver, Children and Family Treatment and Support Services, and Foster Care/29‑I services.
- Research regulations and develop policies, procedures, training materials, PowerPoints, webinars, and guidance documents.
- Conduct HCBS eligibility assessments for waiver applicants, including referrals, initial screenings, information gathering, determining eligibility, enrolling participants, and coordinating transfers to Children’s Health Homes.
- Monitor and analyze reports related to HCBS eligibility and enrollment; provide updates to leadership.
- Provide input on policies and processes related to children’s Medicaid services.
- Assist in maintaining up-to-date content on the DOH website and in drafting program communications.
- Utilize and provide input on enhancements to management information systems.
- Evaluate program implementation and synthesize findings to recommend improvements.
- Collaborate with internal staff, contractors, and state partners on Health Homes, HCBS, and Children’s Services initiatives.
- Perform additional duties as needed to meet evolving program needs within OHIP.
Benefits
- Health, vision, and dental insurance
- 401(k) with discretionary employer match
- Paid time off and holidays
- Flexible spending accounts
- Additional perks
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
