Rehabilitation Program Specialist 2 (20036229)

State of Ohio • Columbus, OH

3d • Hybrid

About The Position

The Ohio Department of Developmental Disabilities (DODD) mission is to partner with people and communities to support Ohioans with developmental disabilities and their families in realizing their version of a good life. Ohio is the heart of opportunity, and we envision Ohio as the best place in the nation for people with developmental disabilities to thrive. Our core values reflect our focus on the experience of each person we support: Inclusion, Partnership, Respect. The Division of Medicaid Development and Administration works with state agency personnel and stakeholders to develop policies related to Medicaid funded services for people with developmental disabilities.

Requirements

• 4 yrs. exp. in private or governmental agency responsible for habilitative &/or rehabilitative programs development in developmental disabilities (i.e., working with individuals with developmental disabilities); bachelor’s degree in professional human services field (e.g., psychology, education, anthropology) in accordance with provisions of 42 CFR 483.430(b)(5)(x) & interpretive guidelines issued by centers for Medicaid & Medicare services.
• Must be willing & able to secure a Driver License OR supply your own transportation.
• The final candidate selected for the position will be required to undergo a criminal background check.
• Counseling and Rehabilitation
• Attention to detail
• Critical thinking
• Establishing relationships
• Ethics and value
• Problem solving
• Time management

Responsibilities

• Act as an RPS2 covering various areas of the Medicaid Unit to ensure that workflow is current.
• Work with supervisor for assignments in all the areas within the division that include Prior Authorization (PA), Nursing Tasking Inventory (NTI), State Funded Behavioral Add-on (SFBAO) and perform all duties of the RPS2.
• Reviewing assessments and/or requests to make determinations related to requests for PA, NTI, and SFBAO; submitted by county boards of developmental disabilities (CBDDs) for initial & ongoing budget review of Medicaid Home & Community-Based Services (HCBS) Waivers.
• Prepares correspondence and hearing rights to send to individuals who are denied services or found to no longer meet necessary requirements for services.
• Prepares hearing summaries and supporting documentation for hearings to submit to the Bureau of State Hearings.
• Reviews assessments submitted by CBDDs & Develops, coordinates, monitors reviews & evaluates Medicaid Home and Community-based Services Waiver prior authorization process & procedures.
• Reviews documentation provided by the appropriate county board of developmental disabilities (CB/DD) to determine if approval criteria are met utilizing federal & state regulations.
• Coordinates with department consultants for programmatic support & assistance with questionable cases or for general consultation.
• Evaluates & makes recommendations of approval of prior authorization, state-funded behavior addons, and nursing waiver budgets when appropriate.
• Makes recommendations for action resulting from information gathered through review process & participates in implementation of such action.
• Conducts reviews in accordance with department’s polices & procedures.
• Develops and write reports in accordance with office procedures.
• Performs records/documentation development/maintenance functions (e.g. develops, sends & receives email & phone communications from involved parties); uses the appropriate DODD applications (including, but not limited to, prior authorizations, state-funded behavior addons, and nursing task inventory processes.
• Collaborates with other department/division staff regarding relationship of prior authorization approval to Payment Authorization of Waiver Services (PAWS).
• Provides testimony at hearings, if necessary.
• Provides support to staff throughout the Department whom have assigned responsibility for the administration of Medicaid processes & procedures (e.g., reviewing & revising policies & procedures related Prior Authorization, nursing and Waiver, to inform policy analysis & development).
• Monitors & evaluates systems activities of local Department of Job & Family Services (DJFS) case workers through Ohio Benefits System (OBS) and Medicaid Systems (e.g., new applications, Medicaid eligibility determinations, appeals, etc.)
• Advises state & local staff on correct procedures to follow to assist applicants to obtain Medicaid eligibility, provides technical assistance & assists in problem solving between DJFS case workers or other systems.
• Implements program policy & procedures that impact waiver eligibility, and Nursing.
• Provides testimony at hearings, if necessary.

Benefits

• Medical Coverage
• Free Dental, Vision and Basic Life Insurance premiums after completion of eligibility period
• Paid time off, including vacation, personal, sick leave and 11 paid holidays per year
• Childbirth, Adoption, and Foster Care leave
• Education and Development Opportunities (Employee Development Funds, Public Service Loan Forgiveness, and more)
• Public Retirement Systems ( such as OPERS, STRS, SERS, and HPRS ) & Optional Deferred Compensation ( Ohio Deferred Compensation )

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level