Program Manager/ Medicaid Managed Care Liaison

We are Hiring!

Job Posting: Program Manager/ Medicaid Managed Care Liaison

Location: 6279 S. Hornell RD, Hornell Ny 14843
Employment Type: Full Time 

Salary: $60,000-$65,000 an hour

General Description

The Program Manager/ Medicaid Managed Care Liaison is responsible for the day-to-day management

and administration of the agency’s foster care services, the coordination of all health-related services to

children in the care of the agency’s foster care program, and the coordination of all Medicaid-related

services to children in the care of the agency’s foster care program. Such services are to be provided in

compliance with all rules and regulations of the New York State Office of Children and Family Services

and Medicaid program.

Essential Duties and Responsibilities

• Coordinates all activities with regard to the day-to-day administration of Medicaid related services and non-Medicaid related services within the Therapeutic Foster Care Program
• Formulates and presents monthly information and program statistical data, providing interpretation of the data as requested in matters related to the activities for which they are responsible.
• Meets monthly with contract agency representatives to assure administration compliance with contractual provisions, review agency relations, resolve presenting problems, and to discuss program planning.
• Works with treatment providers to establish treatment goals.
• Serves as contract coordinator with all foster care health care providers and funders.
• Assists the Finance Office in resolution of billing issues with county Departments of Social Services and foster care health care providers, and MCOs.
• Is responsible for the recruitment, orientation, training, direct supervision and evaluation of therapeutic foster care supervisor, skill building clinician and home Finder.
• Reviews all health care information and records.
• Provides emergency behavioral consultation services.
• Ensures the quality and method of supervisory practice in order to assure consistency and conformity with agency standards for supervisor practices throughout the Therapeutic Foster Care Program.
• Serves as contract coordinator with all foster care Medicaid providers.
• Coordinates with MMCPs, LDSS, and MCOs, including any provider changes.
• Is responsible for oversight of all business functions regarding the Article 29-I Health Facilities License.
• Serves as the primary contact for MMCP’s and assists with placement changes.
• Maintains eligibility for public or private health insurance.
• Coordinates benefits.
• Assists with consent and/or confidentiality issues.
• Ensures the coordination of foster care Medicaid services with other services within the agency in a manner that assures that those served have appropriate access.
• Is readily available via telephone and email to LDSS and the agency during regular business hours to address any issues for managed care enrollees.
• Reports all “Critical Incidents” to the Chief Operating Director, Compliance Officer, and Executive Director as needed.
• Ensures program compliance with Adoption and Safe Families Act (ASFA) guidelines.
• Works with finance team to develop annual foster care budget recommendations for inclusion in the agency’s annual operating budget, in accordance with the approved budget calendar.
• Operates within the Therapeutic Foster Care budget plan.
• Formulates written annual program operational plan that includes program goals, performance objectives and action plans.
• Coordinates a policy and regulatory review process that assures the Therapeutic Foster Care
• Program operates in compliance with current regulatory and established program guidelines, recommending any changes in policies and procedures as needed.
• Ensures that foster care program maintains current procedural manuals making changes as needed.
• Responsible for ensuring foster care certifications and other credentialing requirements are up to date.
• Coordinates an annual plan with the Foster Home Finder for the recruitment and certification of qualified therapeutic foster homes, to assure that the agency as a sufficient number of quality therapeutic foster homes available to meet local need.
• Promotes community understanding of the agency and its services through agency representation at inter-agency conferences, membership on committees, and contributions to the agency’s newsletter.
• Acts as Emergency back-up to all program staff during their on-call rotation.
• Exhibits flexibility to meet the needs of the program.
• Conducts quality oversight and improvement services.
• Advises LDSS regarding medical needs of youth in care.
• Meet & communicate with birth families, guardians, foster families, and caseworkers as needed.
• Provides and documents clinical supervision in accordance with practitioner scope of practice and in compliance with laws and regulations.
• Responsible for any other duties necessary for the TFC Program within their abilities as assigned.

Note: The above description is illustrative of tasks and responsibilities. It is not meant to be all inclusive. Employees are required to follow appropriate supervisory direction and perform other related duties as required.

Qualifications

Education: Bachelor’s degree required, preferably in human services or related field. 

Experience: At least 3 years of experience working in the human services fieldAt least 6 years of relevant professional experience preferred. Knowledge of the Medicaid Managed Care policies and operations. At least one year supervisory experience preferred. Experience in Child Welfare preferred. Relevant years of experience and education will be considered 

Additional Qualifications:

• Extensive daytime travel within a six-county service area, with reimbursement for mileage.
• Possession of a valid NYS Driver’s license and a driver's record considered acceptable by agency and insurance carrier.
• Continuous use of a reliable, registered and insured vehicle.
• Ability to prioritize assignments, plan, and complete work projects with minimal direction
• Exceptional time management skills and ability to effectively and meet deadlines 
• Excellent verbal/written skills
• Ability to work in the following software programs: Windows, Microsoft Office, and multiple online software platforms as required by funders and partner organizations
• Ability to maintain confidentiality and handle confidential information with discretion
• Ability to demonstrate behaviors and attitudes which support organizational mission, philosophy, and policies
• Ability to work in a cooperative and helpful manner with all individuals
• Willingness and ability to foster agency and program wide cooperation and teamwork through use of positive/constructive communication techniques

***Catholic Charities is committed to leveraging the talent of a diverse workforce to create great opportunities for our agency and our people. EOE/AA Disability/Vet

Physical Demands/Work Environment: The physical demands/work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, talk, hear, stand, walk, use hands to type and/or perform light lifting. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The noise level in the work environment is usually quiet.