Supervisor Medicaid Waiver

Golden Gate Regional Center•San Francisco, CA

About The Position

Golden Gate Regional Center (GGRC) is hiring a Supervisor, Medicaid Waiver to oversee the Agency’s Medicaid Waiver (MW) program, determine eligibility for persons served, and coordinate compliance with program requirements. The role researches and resolves Medicaid Waiver issues, provides information to management and other units, and supervises staff and potentially outside consultants. Regional travel is required within San Francisco, San Mateo, and Marin Counties, as well as Northern and Central California, including Sacramento. The position requires access to reliable transportation for travel between multiple locations during the day. The supervisor oversees Medicaid Waiver administration, quality assurance, audits, staff management, and training and development. They work with case management staff and external organizations, including the Department of Developmental Services (DDS) and County Health and Human Services offices, to support accurate documentation, enrollment, and compliance. The role also develops policies, procedures, training materials, audit responses, and corrective action plans. All information must be kept confidential in compliance with HIPAA and the California Lanterman Act.

Requirements

Bachelor’s degree in Nursing or another related field.
At least 5 years of professional experience in health care, health administration, or social services; one year of direct services to people with developmental disabilities is preferred.
At least 3 years of professional experience supervising professional staff.
Strong leadership, training, and facilitation skills.
Ability to understand the Agency’s vision and values and implement changes that support them.
Ability to work with all levels of 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, MS Excel, MS PowerPoint, MS Outlook, or similar applications.
Access to reliable transportation for required regional travel.
Ability to maintain confidential information in compliance with HIPAA and the California Lanterman Act.

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 eligible for Medicaid Waiver and document services in accordance with the Medicaid Waiver Manual.
Collaborate with case managers on quality assurance to ensure case records meet Medicaid Waiver standards for content and consistency.
Inform and educate case management and other staff about Medicaid Waiver documentation and changes in individuals’ status.
Support case management staff in developing Medicaid Waiver-related goals and objectives for individuals’ Individual Program Plans (IPPs).
Ensure enrollment goals are met to secure maximum Agency funding.
Monitor case-record reviews to ensure Medicaid Waiver-level CDER-assessed needs are supported by current documentation.
Instruct, coach, and monitor staff on Medicaid Waiver documentation requirements and changes in status.
Coordinate quality assurance and training so case 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 develop and oversee corrective action plans.
Research and develop case materials and strategies for audit appeals; represent GGRC in audit appeal cases.
Interview, hire, train, and supervise staff; provide guidance and performance feedback.
Hold periodic staff meetings, manage workflow and staff coverage, and 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, help resolve program issues, and conduct orientations for incoming staff.
Participate in special projects and perform additional assigned duties.
Maintain confidential information in compliance with HIPAA and the California Lanterman Act.