Social Services Program Specialist 2

State of Nevada•Northern Nevada, NV

About The Position

The Nevada Medicaid, Managed Care Delivery Systems Unit within the Nevada Health Authority is seeking a Social Services Program Specialist 2 in Carson City or Reno. The successful candidate will join the team of Managed Care Organization (MCO) and Dental Benefits Administrator (DBA) contract monitors. The position ensures compliance with contract requirements by interpreting contracts, policies, and federal regulations; monitoring reports; following complaints through resolution; documenting issues; representing the Unit at Hearing Preparation Meetings; updating and presenting Medicaid Services Manual (MSM) changes at Public Hearings; submitting and tracking data requests and Production Discrepancy Reports; and leading stakeholder meetings as needed. Social Services Program Specialists perform administrative and professional work in the administration of statewide public assistance, medical assistance, or social services programs. Work focuses on program administration, including interpreting laws and regulations, developing policies and procedures, quality assurance and control, preparing reports, and developing or enhancing automated systems that support program operations. Although incumbents may interact with clients to resolve customer service issues, the role is not primarily direct service delivery. Under direction, incumbents perform the full range of duties involved in planning, developing, and implementing comprehensive and complex social services or medical assistance programs. They independently interpret broad or ambiguous statutes and regulations and make day-to-day program administration decisions, while referring controversial matters or decisions with significant program impact to supervisory or management staff. In coordination with higher-level staff, managers, and chiefs, they participate in developing and implementing program components, plans, and policies subject to management review and approval. The role is distinguished from Social Services Program Specialist I by responsibility for more comprehensive and complex programs or grants and greater independence in interpreting statutes and regulations.

Requirements

A bachelor's degree from an accredited college or university in a field pertinent to the program assignment and one year of professional experience providing social services to clients or in program development and evaluation requiring application of regulations, laws, policies, and procedures in making determinations; or
A bachelor's degree from an accredited college or university in a field pertinent to the program assignment and one year of professional experience providing medical assistance programs, services, or healthcare services to clients, or in program compliance and evaluation requiring application of regulations, laws, policies, and procedures in making determinations; or
One year of experience as a Social Services Program Specialist I in Nevada State service; or
An equivalent combination of education and experience as described above.
Working knowledge of social services and resources applicable to the assigned program and methods for administering social or medical assistance programs in compliance with federal regulations and State law.
General knowledge of assigned program purpose and scope; appeal and hearing processes; automated information system logic; data processing concepts; computer technologies; and principles and practices for developing and presenting training.
Ability to develop routine databases; evaluate program effectiveness; recommend improved procedures; mediate between contending parties; coordinate program activities; interpret broad, ambiguous, or conflicting regulations and laws; and make independent decisions affecting service quality.
Ability to resolve complex issues and compliance problems, identify policy matters requiring management resolution, communicate system needs to programmers, validate programming, and prepare system documentation.
Ability to conduct needs assessments, develop training curricula and materials, prepare statistical and analytical reports, interpret budgets and financial statements, coordinate program activities, plan and conduct meetings, and communicate findings clearly.
Skill in troubleshooting computer operating problems.

Responsibilities

Participate in planning and developing social services or medical assistance programs, including conducting needs assessments, researching and evaluating programs, identifying resources, calculating impacts, preparing recommendations, applying for grants, drafting proposed legislation, and developing program plans.
Develop and revise program documentation, including State plans, policy manuals, procedures, and contracts, and interpret federal regulations and State laws to support compliant program operations.
Monitor program quality and compliance; design monitoring instruments, review reports and records, conduct on-site reviews, document findings, and develop corrective action plans.
Provide technical assistance and guidance to program staff and respond to information requests; clarify policies, interpret regulations, provide statistics, complete surveys, resolve complaints, and draft correspondence.
Conduct research studies, gather and analyze data, prepare reports, and develop recommendations.
Prepare and monitor program operating budgets, allocate funds, track revenue and expenditures, and propose funding adjustments.
Promote social services or medical assistance programs; serve as a spokesperson and liaison with program personnel, providers, community groups, media, and government officials.
Develop and implement training programs, curricula, materials, schedules, and training sessions, and evaluate and update training.
Provide technical guidance and consultation to service providers regarding policies, procedures, regulations, and problematic cases.
Participate in developing, maintaining, and enhancing computerized systems, including researching user needs, requesting system changes, testing changes, and preparing system documentation.
Monitor MCO and DBA contract compliance; interpret contracts, policies, and federal regulations; monitor reports; follow complaints through resolution; document issues; represent the Unit at Hearing Preparation Meetings; present MSM changes at Public Hearings; track data requests and Production Discrepancy Reports; and lead stakeholder meetings as needed.
Perform related duties as assigned.