PCA Program Specialist
About The Position
The PCA Program Specialist is responsible for the day-to-day oversight, coordination, and compliance of the Personal Care Assistant (PCA) Program. This position ensures that all program activities, documentation, and billing processes are completed accurately and in accordance with Medicaid requirements, organizational policies, and applicable regulations. The role supports quality service delivery by reviewing and maintaining required documentation, monitoring member eligibility, conducting home visits and recertifications, and performing routine audits to ensure compliance and program integrity. This position serves as a central point of contact for PCA staff, members, families, and external partners, and assists in resolving concerns, coordinating services, and implementing necessary adjustments to meet member needs. The PCA Program Specialist plays a critical role in ensuring timely billing, accurate reporting, and continuous improvement of PCA services while supporting high-quality, member-centered care.
Requirements
- Associates degree or equivalent, (may have a combination of education and experience in lieu of degree)
- Valid Montana Driver's License
Responsibilities
- Oversees the PCA Program, ensuring reports are completed accurately.
- Responsible for reviewing the PCA Service Delivery Records (SDR) and ensuring completeness and accuracy.
- Responsible for submitting SDR and PCA billing excel worksheet to Supervisor monthly.
- Responsible for reviewing and faxing applications to MPQH.
- Home visits to members as needed.
- Conducts quarterly audits to ensure all documentation is complete.
- Conducts the required 180 day and Annual Recertification in the home on members due.
- Verifies Medicaid eligibility on members each month.
- Makes scheduled changes continuously to accommodate changes in recipient’s needs, additional recipients, emergency cases, and other factors necessitating changes in recipient needs.
- Evaluates, assists in explaining and following up with corrective actions regarding all recipient and family complaints reported.
- Assists with necessary documentation requirements for Medicaid billing.
- Reports and assists in resolving complaints and other problems of the PCA Program.
- Serves as liaison for PCA being principle contact for many sources and workers.
- Other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
Number of Employees
11-50 employees
