907.276.5707 Admin@akexec.com

Medicaid Compliance Manager

Location: Anchorage, Alaska
Date Posted: 08-31-2018
Position:       Medicaid Compliance Manager
Location:       Anchorage
Pay Range:    DOE
 
This position is responsible for monitoring the compliance and quality of the Medicaid Waiver program within the organization.  It will be the point of contact and interpretation for all Waiver related material and information for the organization.  The Compliance Manager also assists staff in communicating with Care Coordinators and negotiating services. The position may require de-escalating verbally physically aggressive individuals according to procedures and individual client protocols.
 
Duties and Responsibilities:
  • Responsible for interpreting regulations, establishing standards and performing quality control of all associated agency responsibilities, procedures and services ensuring adherence to State and Federal regulations.
  • Coordinates monitoring of administrative and procedural tasks related to applications, Agency Certification and Waiver enrollments
  • Conducts regular compliance reviews, responsible for assurance of compliance, recommends modifications to ensure ongoing and consistent compliance
  • Directs plan development, ensures clinical appropriateness of Waiver plans, monitors the quality of Waiver treatment plans
  • Represents organization in conferences/committees and attends trainings regarding Waiver Services
  • Negotiates services and funding on behalf of individuals and the organization
  • Assists in determining frequency and duration of services to meet client needs
  • Work collaboratively with Finance Department regarding Waiver billing procedures
  • Develops and facilitates internal staff trainings
  • Assists or individually de-escalates verbally or physically aggressive individuals
  • Other duties as assigned
 
Essential Qualifications:
  • Three years of full time experience working with individuals experiencing developmental disabilities and/or mental health illness, of which one year should be managing Home & Community Based Waiver services
  • Minimum of one year direct involvement assuring compliance with either Senior and Disabilities Services regulations or State of Alaska Assisted Living Regulations
  • High School Diploma or GED required
  • Ability to read and interpret medical records, reports, safety rules, state and federal regulations, and procedure manuals. Ability to write reports, treatment plans, Plans of Care and correspondence. Ability to speak effectively to groups
  • Must have thorough understanding of waiver budgets and Medicaid billing
  • Must demonstrate leadership and supervisory abilities
  • Effective communicator both verbally and in writing
  • Advanced public relations and advocacy skills
  • Proactive team building skills
  • Knowledge of basic accounting, Medicaid regulations, budget development and administration
  • Ability to assess treatment of individuals experiencing physical and/or mental disabilities
  • Knowledge of Word, Excel, Access and PowerPoint
  • Must have valid Alaska driver’s license and insured vehicle
 
All qualified candidates who meet or exceed the above Position Qualifications or have relevant experience will be contacted.
 
AES provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. While working within the parameters of an Alaska Native Organization, hiring preference will be given to shareholders/spouses/descendants and other Alaska Natives in accordance with Public Law 93-638.

AES matches job seekers with opportunities in which they are recognized and rewarded for their experience, skills and abilities.  AES is proud to be an Alaskan-owned company building relationships on integrity and trust since 1977. Our Services are always FREE to candidates. 
 
POSITION OPEN UNTIL FILLED
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