Supervisor Medicaid Waiver

Golden Gate Regional Center•San Francisco, CA

1d•$75,518 - $90,621

About The Position

Golden Gate Regional Center (GGRC) is hiring a Supervisor, Medicaid Waiver to supervise the Medicaid Waiver (MW) Program, determine Medicaid Waiver eligibility for people served, and oversee and coordinate program requirements throughout the agency. The role researches and resolves Medicaid Waiver issues, provides information to management and other units, and supervises staff and potentially outside consultants. The position requires regional travel within San Francisco, San Mateo, and Marin counties, as well as Northern and Central California, including Sacramento. Reliable transportation that permits travel among multiple locations throughout the day is required. The supervisor administers and oversees Medicaid Waiver documentation, recertification, quality assurance, audits, staff management, and training. The role serves as GGRC’s primary liaison with external Medicaid Waiver organizations, including DDS and County Health and Human Services Offices. The position also maintains confidentiality in compliance with HIPAA and the California Lanterman Act.

Requirements

Bachelor’s degree in nursing or another related field.
Five or more years of professional experience in health care, health administration, or social services; one year of direct services to people with developmental disabilities is preferred.
Three or more years of professional experience supervising professional staff.
Strong leadership skills.
Training and facilitation skills.
Ability to understand the agency’s vision and values and implement changes within the unit to support them.
Ability to work with all levels within the organization.
Knowledge of Medicaid Waiver regulations and GGRC case management principles and procedures.
Ability to communicate complex information and ideas clearly, concisely, and professionally.
Project management proficiency.
Strong attention to detail and analytical skills.
Intermediate knowledge of MS Word, Excel, PowerPoint, Outlook, or similar software applications.
Ability to provide direction and purpose focused on quality, efficiency, and outcomes.
Ability to foster a customer-service environment, coach and support staff, provide real-time feedback, address performance, and hold staff accountable.
Problem identification, analysis, and analytical thinking skills.
Ability to implement initiatives successfully through follow-up and project management.
Self-direction and initiative.
Respect and cultural awareness, including the ability to manage one’s reactions effectively.
Ability to build partnerships and trust through collaboration, active listening, and openness to new ideas.
Ability to adapt to multiple and competing priorities and focus on key job outcomes.
Access to reliable transportation for regional travel among multiple locations.

Nice To Haves

Familiarity with Medicaid Waiver regulations and case management procedures.
Experience in multicultural settings and/or multilingual capacity.
One year of direct services to people with developmental disabilities.

Responsibilities

Review case records to ensure qualifying conditions are supported by current documentation.
Recertify individuals who are eligible for Medicaid Waiver.
Document Medicaid Waiver persons served in accordance with the Medicaid Waiver Manual.
Coordinate quality assurance with case managers to ensure case records meet Medicaid Waiver standards for content and consistency.
Inform, educate, and advise case management and other staff about Medicaid Waiver documentation and changes in individuals’ Medicaid Waiver status.
Advise case management staff on Medicaid Waiver-related goals and objectives for Individual Program Plans (IPPs).
Ensure enrollment goals are met to secure maximum agency funding.
Monitor review of case records to ensure Medicaid Waiver-level CDER assessed needs are supported by current case-file documentation.
Instruct, coach, and monitor GGRC staff regarding Medicaid Waiver documentation requirements and changes in status.
Coordinate quality assurance and case management staff training to ensure records comply with Medicaid Waiver requirements.
Serve as GGRC’s primary liaison with external Medicaid Waiver organizations, including DDS and County Health and Human Services Offices.
Refer, coordinate, and follow up on Institutional Deeming Referrals.
Ensure diagnostic CDER information is updated and accurate.
Participate in ARCA Federal Programs committee meetings.
Develop audit protocols and coordinate file reviews.
Review audit reports and present findings to the manager.
Coordinate GGRC responses to audit cases.
Develop internal controls and oversee corrective action plans for outstanding audit issues.
Research and develop case materials and strategy for audit appeals, and represent GGRC in audit appeal cases.
Interview, hire, train, and supervise staff.
Provide staff guidance and performance feedback, and hold periodic meetings to share information and gather feedback on procedures.
Manage workflow and staff time and coverage to ensure individual and unit goals are met.
Maintain expertise in external regulations through formal and self-directed training.
Oversee development of Medicaid Waiver manuals, policies, and procedures.
Develop curricula and conduct staff training on new and updated regulations, policies, and procedures.
Advise staff on procedures and help resolve program issues.
Conduct regular orientations for incoming staff.
Participate in special projects and perform additional duties as assigned.
Maintain confidential information in compliance with HIPAA and the California Lanterman Act.