26/27 Special Programs Specialist - Medicaid

Buckeye Elementary School District • Buckeye, AZ

1d

About The Position

Under the direction and supervision of the Director of Special Education (or designee), oversee and manage the District’s Medicaid program to ensure compliance with state and federal regulations, maximize reimbursement, and provide strategic oversight of Medicaid billing, reporting, and provider enrollment processes.

Requirements

• Valid AZ DPS IVP Fingerprint Clearance Card
• Minimum of High School Diploma or equivalent certificate (required)
• Valid Driver’s License
• Demonstrated experience with Medicaid billing, compliance, or school-based Medicaid programs
• Knowledge of special education services, IEP processes, and Medicaid eligibility requirements
• Strong analytical, organizational, and problem-solving skills
• Ability to interpret and apply federal, state, and district policies and procedures
• Exhibited ability to work independently and exercise professional judgment
• Intermediate to expert experience level in working with Microsoft Suite and Google Suite, particularly with excel and google sheets
• Excellent communication skills and demonstrated ability to work effectively with various stakeholders
• Evidence of ability to effectively use technology to perform duties
• Such alternatives to the above qualifications as the Board may find appropriate and acceptable.

Responsibilities

• Oversee the District’s Medicaid program to ensure compliance with all federal, state, and district regulations.
• Prepare and submit quarterly and annual cost reports, providing a detailed and accurate account of program expenditures.
• Prepare, review, and submit Reports on Provider Activity (ROPA)
• Manage the provider enrollment and revalidation process, including adding and removing billable providers.
• Monitor overlapping service reports, Random Moment Time Study (RMTS) data, and other compliance indicators.
• Maintains reports and documentation in preparation for agency related audits and any other program-specific audits.
• Audit and verify Medicaid billing for all providers prior to claim submission and resolve complex billing issues or denials.
• Creates and disseminates clear, concise, and useful financial reports and analysis for various stakeholders.
• Serve as the primary point of contact for external audits, monitoring reviews, and compliance inquiries.
• Process and approve Health Aide Authorizations for service minutes exceeding established thresholds.
• Assists with the development and update of District procedures, ensuring they align with district policies and Federal and State law and regulation.
• Conduct Medicaid training sessions for providers to ensure accurate documentation and billing practices.
• Collaborate with the Employee Relations Department to ensure meeting with new special education staff, particularly paraprofessionals, to provide program orientation and guidance upon hire and to ensure employees are removed from the system upon separation.
• Maintain high-level oversight of staff pool lists and contracted provider documentation.
• Process and authorize requisitions and purchase orders related to Special Education Medicaid services.
• Assist administration with expanding Medicaid billing opportunities and improving revenue capture.
• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies to stay informed of current regulations and compliance requirements.
• Support continuous improvement by recommending process efficiencies and internal control enhancements.
• Maintain a high level of ethical behavior.
• Perform other duties as assigned.

Benefits

• Earned Paid Sick Time (up to 5 days)
• Personal Business Leave (up to 7 days)
• Vacation accrual based on tenure (up to 5-15 days)
• Mandatory participation in the Arizona State Retirement System (ASRS)
• District fully paid Medical, Dental, Vision, and Basic Life Insurance & AD&D benefits for employee only

What This Job Offers

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