POSITION SUMMARY:
Leads and manages a staff of seven professionals charged with operating, coordinating, and implementing Prince George's County Public Schools (PGCPS) Medicaid fee-for-service program, a $7 million operation annually. The incumbent will be charged with optimizing efforts to maximize recovery of Medicaid revenue in order to expand and enhance services provided to PGCPS Special Education students.
DUTIES and RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
Collaborates closely with reciprocal units within the Office of Special Education, other offices within the Office of the Chief Financial Officer, the Medical Assistance Administration, and the Health Care Finance Administration to ensure financial, legal and regulatory compliance in maximizing receipt of Medicaid reimbursement for health related services provided to students;
Develops, reviews, and negotiates Medicaid cost reports and cost settlements. Coordinates the tracking of costs associated with rates paid by the Medical Assistance Administration;
Monitors the regular and reiterative billing of all services. Monitors a billing system charged with recovery from Medicaid for all direct student services and administrative services pursuant to special education and health care related services;
Oversee and improve processes related to electronic verification of Medicaid eligibility, electronic claims submission and record storage;
Devises and implements feedback systems, performance measures and benchmarks, to assure adequate Unit performance and successful achievement;
Develops Unit's spending plans and participates actively in the development, preparation and management of the Unit's budget;
Develops and initiates periodic studies and surveys to evaluate ongoing operations and practices, to chart progress toward goal achievement and organizational objectives;
Reports on status of Unit's compliance with the organizational, legislative and statutory requirements;
Communicates and liaises with medical assistance providers, facilitates access to the system for potential eligible families, and monitors the development, implementation and ongoing program review of the PGCPS Medicaid program;
Facilitates and provides training and ongoing support to service providers and school liaisons related to case coordination and case encounter reporting;
Oversees maintenance of the database used to bill and obtain reimbursement for services provided to Medicaid-eligible students and ensures that billing, monthly reports and other documentation required by local, state and federal authorities is provided in a timely manner;
Acts as Medicaid contact for Maryland State Department of Education (MSDE), Department of Health and Mental Hygiene (DHMH) and other state agencies, and contact person in the PGCPS for program, compliance and other Medicaid audits;
Supervises Medicaid school liaisons, technical and program specialists; and
Performs other duties as assigned.
QUALIFICATIONS:The requirements listed below are representative of the knowledge, skill, and/or ability required.
Demonstrated ability to develop, implement and administer a program, to coordinate a number of functions, to manage a service contract and maintain fiscal accountability for a program;
Excellent quantitative and PC skills, especially with spreadsheet, database and work processing software;
Experience working with County and State Agencies, as well as auditors and other fiscal authorities; and
Excellent oral and written communication skills, as well as effective interpersonal skills.
EDUCATION and/or EXPERIENCE REQUIREMENTS:
Bachelor's degree in Accounting, Finance, Business or Public Administration; Master's degree preferred. Minimum six (6) years professional experience, three (3) years at the supervisory level, with Medicaid Assistance Program or other programs serving populations with comparable demographics, such as Head Start
CERTIFICATION REQUIREMENTS:
CPA certification preferred.
SUPERVISORY RESPONSIBILITIES:
Supervisory responsibility for a staff of seven employees.
PHYSICAL DEMANDS:
The physical demands 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 stand, talk, hear, walk, sit, and use fingers, tools or controls. The employee is occasionally required to reach with hands and arms and stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include close vision such as to read handwritten or typed material, the ability to adjust focus, and depth perception. While performing the duties of this job, the employee may occasionally push or lift up to 25 lbs.
WORKING ENVIRONMENT:
The work environment characteristics are representative of those an employee encounters while performing the essential functions of the job.
ADDITIONAL INFORMATION:
None.