Job Description

Posting Number

Position Number

Position Type

Essential Job Duties

Is Time Limited

Job City & State

Classification Title

Working Title

Work Schedule

Other Work/Responsibilities

• 1. Convene two (2) stakeholder meetings per year to seek stakeholder feedback and to provide an update on waiver programs.
  2. Conduct an unbiased review of program requests to resolve concerns and issues raised by a waiver participant or primary caregiver.
  3. Create quality improvement plans marketing and outreach materials on target populations for waiver enrollment to distribute to physicians, discharge planners, nursing facilities, schools, community-based organizations, case management entities, and other health care organizations.
  4. Collaborate with stakeholders, including association, advocacy groups, health care providers and other pertinent provider groups to promote understanding and efficiency in program processes.
  5. Collaborate with case management entities to provide training and instruction on quality improvement initiatives and manage each initiative to track remediation efforts and compliance.
  6. Create and update standard operating procedures to align with results of quality initiatives strategies and program requirements.

Minimum Experience/Education

• Master’s degree in Public Administration, Public Policy, Public Health, Nursing, Social Work from an appropriately accredited institution and three years of long-term services and support and home and community-based services or related experience; or

• Bachelor’s degree in Public Administration, Public Policy, Public Health, Nursing, Social Work from an appropriately accredited institution and four years of long-term services and support and home and community-based services or related experience; or
• Licensed to practice as a Nurse in the State of North Carolina and two years of long-term services and support and home and community-based services; or
  
  
• an equivalent combination of education and experience.

Department Required Skills

• Proven ability to communicate effectively and professionally with employees, managers, and the public (in-person, online, in writing, and on the phone)
• Proficient in Microsoft Office products, including Word, Excel, and Outlook
• Ability to establish and maintain effective working relationships with other state agencies, providers of services, advocacy groups, and other organizations
• Ability to work independently with minimum or no supervision
• Ability to effectively manage multiple tasks and priorities
• Proven experience in collecting and analyzing programmatic data
• Working knowledge of long-term care supports and services and home and community-based care
• Proven ability to interpret and apply complex Federal and State regulations

Preferred Years Experience, Skills, Training, Education

• Strong understanding of the Medicaid delivery system or health industry knowledge; associated policies, processes, and operations; and the relevant systems and data trends.
• Working knowledge of quality improvement strategies and corrective actions
• Ability to evaluate and analyze cases for Medicaid programs requiring problem solving and critical thinking skills
• Proven ability to research and verify information provided by Medicaid beneficiaries and provider agencies
• Knowledge of Medicaid and Medicare programs and third-party payer methods.
• Experience in management and administration of federal or state programs.

Required License or Certification

Valid NC Driver's License required?

Commercial Driver's License Required?

Anticipated Hiring Range

Job Open Date

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