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Nature of Work
This position is responsible for program administration and operational functions necessary to ensure compliance with state and federal policies and regulations in an efficient and cost-effective manner.
This position will:
Be responsible for monitoring all aspects of the grant monies awarded by the American Rescue Plan Act (ARPA) of September 2021 to any Home and Community Based Services (HCBS) program of the West Virginia Bureau of Medical Services.
Have oversight of the monies awarded, final products developed, and work staff that monitors all aspects of contracts and grants, including federal reporting to the Centers for Medicare and Medicaid Services, data policy clarification and guidance for the Medicaid Managed Care Organizations (MCO), and approval of all educational materials provided to the Waiver Program Managers for educating their providers of the product and services available through vendors.
Provide directions and education to all HCBS providers and any MCOs to ensure the data they receive is also reviewed and trends are identified and reported.
Develop quality measures and report requests for each program that is shared internally and externally.
Monitor the Electronic Visit Verification (EVV) contract and vendor to ensure that providers are using the system properly, review reports to identify trends and compliance with the system, and to discover possible Medicaid fraud, and report suspicions to the proper authorities.
Monitor the WV Incident Management System (WVIMS) contract to ensure that service delivery, state regulations, and contract deliverables are met.
Represent the agency at various local, state, and federal venues as an agency expert on the ARPA funds, Electronic Visit Verification, and WVIMS.
Supervise two Health and Human Resources Specialists and will develop a policy manual for the future online HCBS case management system.
Other duties as assigned.
Minimum Qualifications
Training: Master's degree from an accredited college or university in the area of assignment.
Substitution: One year of full-time or equivalent part-time paid experience as described below may substitute for the Master's degree.
Experience: Three years of full-time or equivalent part-time paid professional experience in the area of assignment, one year of which must have been in a program administration capacity.
Substitution: Post-graduate training in the area of assignment may substitute through an established formula for the non-supervisory experience.