PROVIDER COMPLIANCE LEAD - 67016626

State of Florida

22h • $60,000 - $65,000 • Onsite

About The Position

This is a highly responsible position serving the Agency for Persons with Disabilities (APD) State Office whose role includes but is not limited to, providing statewide coordination, direction and specific technical assistance to Regional APD offices regarding programs within the APD services system.

The Lead Provider Compliance Coordinator is responsible for providing technical and functional recommendations, leadership and guidance, regarding the workflows in provider terminations, Provider adverse actions, Changes of Ownership (CHOW), and background screenings. This role requires a combination of leadership, project management, and provider action expertise to drive the effectiveness of the Provider Relations Unit. Foster a positive and collaborative team environment, promoting professional growth and development among team members. Conduct regular team meetings to facilitate communication and knowledge sharing.

Requirements

• Proficiency with Microsoft Word and Excel.
• High School diploma or its equivalent.
• Knowledge of: DD/HCBS Medicaid Waiver and Florida's Developmental Disabilities system.
• Rules, policies, procedures and laws related to the DD/HCBS iBudget Waiver program.
• Ability to: Develop rules, policies and procedures related to Florida's Waiver and Medicaid program.
• Understand, apply and interpret applicable statutes, rules, regulations and policies related to the waiver program.
• Communicate effectively both in writing and verbally.
• Establish and maintain effective working relationships with coworkers, Field Office staff, consumers, family members and other stakeholders.
• Work independently.
• Learn and communicate complex information.
• Plan, organize and coordinate work assignments.
• Demonstrate Skills in: Producing information, data analysis, and reports to executive leadership.

Responsibilities

• Coordinates, processes, monitors and tracks provider action and termination requests which includes but is not limited to the following, Monitors provider actions inbox daily to ensure incoming work is tracked and organized.
• Delivers technical assistance and information to unit staff and regional staff.
• Notifies regional offices of termination review decisions in a timely and professional manner.
• Organizes cases and facilitates staff reviews with the Office of General Counsel and Operations.
• Ensures that terminated providers are closed in all relevant APD and AHCA systems.
• Creates and presents summary data reports on provider terminations to management.
• Acts as liaison with Agency for Health Care Administration and the Medicaid fiscal agent.
• Coordinate with the Medicaid fiscal agent, providers, and regional offices regarding provider actions.
• Provide technical assistance and training to Regional staff regarding all aspects of provider actions and terminations.
• Update relevant data systems with provider information.
• Collaborate with communications to create revisions to provider web content.
• Provide technical assistance to current providers on provider record maintenance.
• Compile reports, review trends, and develop processes in response to data to improve processes.
• Coordination of Provider Background Screening application processing.
• Assist the Regions in the coordination of all CHOW process steps.
• Manage unit initiatives to ensure successful and timely completion.
• Perform other duties as assigned.

Benefits

• Annual and Sick Leave benefits.
• Nine paid holidays and one Personal Holiday each year.
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
• Retirement plan options, including employer contributions (For more information, please click www.myfrs.com).
• Flexible Spending Accounts.
• Tuition waivers.
• Paid Maternity and Parental Leave.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED