Medicaid Program Manager
About The Position
The Office of Aging & Long-Term Care is seeking a Medicaid Program Manager to support the Center for Home and Community Based Services in its mission to rebalance New York State's long-term care system from institutional care to home and community-based services. This position plays a critical role in supporting the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Medicaid Waiver Programs. The successful candidate will help ensure compliance with Centers for Medicare & Medicaid Services (CMS) requirements while overseeing participant complaint resolution, quality assurance initiatives, and stakeholder engagement efforts that enhance service delivery and participant outcomes.
Requirements
- Bachelor's degree and equivalent professional experience, or a combination of education and experience.
- 10+ years of professional experience in healthcare administration, Medicaid programs, human services, long-term care, public health, or a related field.
- 5+ years of subject matter expertise in Medicaid, waiver programs, managed care, healthcare compliance, or related program operations.
- Demonstrated supervisory or team leadership experience.
- Experience managing complex investigations, case reviews, compliance activities, or quality assurance initiatives.
Nice To Haves
- Experience with Home and Community-Based Services (HCBS), Medicaid Waiver Programs, NHTD, TBI, or long-term services and supports (LTSS).
- Knowledge of CMS regulations and Medicaid program requirements.
- Strong written and verbal communication skills.
- Excellent organizational, analytical, and problem-solving abilities.
- Experience facilitating meetings and collaborating with diverse stakeholder groups.
- Advanced proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
- Ability to prepare detailed reports, executive summaries, and presentations for leadership.
Responsibilities
- Oversee and manage quality assurance activities for the NHTD and TBI Waiver Programs.
- Lead the waiver participant complaint process, ensuring timely investigation and resolution of concerns.
- Serve as the primary point of contact for waiver participant cases.
- Investigate participant complaints, critical incidents, abuse, neglect, and participant harm allegations.
- Collaborate with Regional Resource Development Centers (RRDCs), Service Coordinators, and provider agencies to address and resolve participant concerns.
- Ensure waiver program compliance with federal CMS standards and regulations.
- Interact with CMS staff and external stakeholders regarding waiver operations and regulatory requirements.
- Monitor program performance and identify opportunities for continuous quality improvement.
- Provide technical assistance and guidance to RRDCs, program service agencies, and internal Department of Health teams.
- Interpret and clarify waiver policies, procedures, and program manuals.
- Identify opportunities for stakeholder education and participant engagement.
- Serve as a liaison across Department of Health bureaus to support coordinated program operations.
- Conduct periodic reviews of waiver service quality and participant outcomes.
- Develop reports, recommendations, and program analyses for leadership.
- Identify operational efficiencies and process improvement opportunities.
- Facilitate meetings and present findings to internal and external stakeholders.
Benefits
- Medical, dental, and vision insurance
- 401(k) with discretionary employer match
- Paid time off and holidays
- Flexible spending accounts
- Additional employee perks
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What This Job Offers
Job Type
Full-time
Career Level
Senior
