Provider Compliance Lead
State of Florida
full-time
Posted on:
Location Type: Office
Location: Tallahassee • Florida • United States
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Salary
💰 $60,000 - $65,000 per year
Job Level
About the role
- Provide statewide coordination, direction and specific technical assistance to Regional APD offices regarding programs within the APD services system.
- Provide technical and functional recommendations, leadership and guidance regarding the workflows in provider terminations, Provider adverse actions, Changes of Ownership (CHOW), and background screenings.
- Foster a positive and collaborative team environment, promoting professional growth and development among team members.
- Conduct regular team meetings to facilitate communication and knowledge sharing.
- Monitor provider actions inbox daily to ensure incoming work is tracked and organized.
- Deliver technical assistance and information to unit staff and regional staff.
- Notify regional offices of termination review decisions in a timely and professional manner.
- Organize cases and facilitate staff reviews with the Office of General Counsel and Operations.
- Ensure that terminated providers are closed in all relevant APD and AHCA systems.
- Create and present summary data reports on provider terminations to management.
- Act as liaison with Agency for Health Care Administration and the Medicaid fiscal agent.
- Coordinate with the Medicaid fiscal agent, providers, and regional offices regarding provider actions.
- Provide technical assistance and training to Regional staff regarding all aspects of provider actions and terminations.
- Update relevant data systems with provider information.
- Collaborate with communications to create revisions to provider web content.
- Provide technical assistance to current providers on provider record maintenance.
- Compile reports, review trends, and develop processes in response to data to improve processes.
- Coordinate Provider Background Screening application processing.
- Assist the Regions in the coordination of all CHOW process steps.
- Manage unit initiatives to ensure successful and timely completion.
Requirements
- Proficiency with Microsoft Word and Excel.
- High School diploma or its equivalent.
- Knowledge of DD/HCBS Medicaid Waiver and Florida's Developmental Disabilities system.
- Rules, policies, procedures and laws related to the DD/HCBS iBudget Waiver program.
- Ability to develop rules, policies and procedures related to Florida's Waiver and Medicaid program.
- Ability to understand, apply and interpret applicable statutes, rules, regulations and policies related to the waiver program.
- Ability to communicate effectively both in writing and verbally.
- Ability to establish and maintain effective working relationships with coworkers, Field Office staff, consumers, family members and other stakeholders.
- Ability to work independently.
- Ability to learn and communicate complex information.
- Ability to plan, organize and coordinate work assignments.
- Skills in producing information, data analysis, and reports to executive leadership.
Benefits
- Annual and Sick Leave benefits.
- Nine paid holidays and one Personal Holiday each year.
- State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
- Retirement plan options, including employer contributions.
- Flexible Spending Accounts.
- Tuition waivers.
- Paid Maternity and Parental Leave.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisreportingprovider record maintenanceprovider background screeningworkflow managementtechnical assistancecase organizationprovider termination processesrules and policy developmentstatute interpretation
Soft Skills
communicationcollaborationteam leadershipprofessional developmentindependent workorganizational skillsrelationship buildingproblem solvingknowledge sharingtraining
Certifications
High School diploma or equivalent