PROVIDER LIAISON - 67016244

State of Florida • West Palm Beach, FL

6d • $38,264 - $41,025 • Onsite

About The Position

This is a professional position responsible for independently performing a variety of duties related to quality improvement and enhancement of provider service delivery practices, training and technical assistance, researching provider related complaints, ensuring providers who are not in compliance submit and follow a plan of remediation which is responsive to cited deficiencies, directing providers to the Agency for Health Care Administration (AHCA) when billing discrepancies are identified, documenting communication with providers and stakeholders to address identified concerns, collaborating with external stakeholders including the Quality Improvement Organization (QIO), Medicaid Program Integrity (MPI) and the Medicaid Fraud Control Unit (MFCU) as while upholding HIPAA requirements. The incumbent’s duties include, but are not limited to, the following:

Review the QIO reports and identify deficiencies needing correction. Notify the provider of deficiencies needing correction and provide a plan of remediation template for provider completion.

Review the provider plan of remediation to ensure all deficiencies are remediated within required timeframes and add remediation activities onto the remediation tracker.

Follow up with the provider to ensure all rights and health and safety alerts are addressed within required timeframes.

Follow up on any provider complaints received. Ensure any identified client health and safety issues are immediately addressed.

Require a plan of remediation for all verified complaints.

Add the complaint onto the remediation tracker.

Assist in completion of the Provider Adverse Action Request Form for request for administrative complaints or provider terminations.

Ensure that a Corrective Action Plan is generated for all deficiencies involving APD licensed facilities in annual QIO reviews.

Collaborate with the APD waiver team and clinical team in researching complaints.

Collaborate with external agencies (MPI, QIO, MFCU) in addressing provider performance concerns.

Perform other related duties as assigned.

Requirements

• Highschool Diploma or its equivalent.
• Valid Driver’s license or other efficient means of transportation and willing to travel for work purposes.
• Knowledge of Microsoft Office Programs (Word, Excel, Outlook, Teams, SharePoint).
• Knowledge of iConnect to complete business processes.
• Ability to provide responsive customer service.
• Ability to work with individuals with developmental disabilities.
• Ability to multi-task effectively.
• Ability to use tracking systems to monitor and complete work assignments within required timeframes.
• Ability to travel to complete wellness visits, attend provider quarterly meetings, attend other meetings as assigned.

Responsibilities

• Review the QIO reports and identify deficiencies needing correction. Notify the provider of deficiencies needing correction and provide a plan of remediation template for provider completion.
• Review the provider plan of remediation to ensure all deficiencies are remediated within required timeframes and add remediation activities onto the remediation tracker.
• Follow up with the provider to ensure all rights and health and safety alerts are addressed within required timeframes.
• Follow up on any provider complaints received. Ensure any identified client health and safety issues are immediately addressed.
• Require a plan of remediation for all verified complaints.
• Add the complaint onto the remediation tracker.
• Assist in completion of the Provider Adverse Action Request Form for request for administrative complaints or provider terminations.
• Ensure that a Corrective Action Plan is generated for all deficiencies involving APD licensed facilities in annual QIO reviews.
• Collaborate with the APD waiver team and clinical team in researching complaints.
• Collaborate with external agencies (MPI, QIO, MFCU) in addressing provider performance concerns.
• Perform other related 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.
• 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