Director of Medicaid, Council on Aging
Location:   Cincinnati, OH
Salary:   based on experience
THE OPPORTUNITY: Join the mission-driven team at Council on Aging, where no matter your role, you are valued as an integral part of our work improving quality of life and promoting independence for older adults and people with disabilities in our community.
- Want to work with one of the fastest growing populations in the United States?
- Have a desire to improve outcomes, promote independence and enhance quality of life for individuals of all ages?
- Want to work for an organization whose mission and values you believe in, and where you are respected and valued as an employee?
If your answer is yes, then Council on Aging has a challenging and rewarding career opportunity for you.
ABOUT COUNCIL ON AGING:
Council on Aging of Southwestern Ohio (COA) is a nonprofit organization dedicated to enhancing quality of life for older adults, people with disabilities, their families and caregivers. We promote choice, independence; dignity and well-being through a range of services that help people remain in their homes for as long as possible.
Our mission: Enhance people’s lives by assisting them to remain independent at home through a range of quality services.
JOB SUMMARY: To execute, implement and measure program strategies that are consistent with Medicaid operations and COA strategic plan. This position is to oversee contract compliance, quality, productivity, and serve as medical director for health and safety issues
Essential Job Functions and Responsibilities:
- Serves as a key member of the Medicaid Operations team to drive business strategies and objectives and to ensure appropriate utilization and compliance of the program operations in overall strategy achievement.
- Implements initiatives, either directly or indirectly, within parameters of the strategic plan ensuring compliance with all program requirements.
- Oversees risk management strategies to mitigate risk in program operations that could result in health and safety or program integrity losses.
- Monitors medical, clinical and operational compliance and develop initiatives for improvement.
- Advises COA’s Senior Leadership Team on key clinical, compliance and program issues and trends.
- Assist VP of Medicaid in preparation of program reports for the Chief Executive Officer, Board of Trustees, and government agencies.
- Manages and monitors agency compliance with external program audits.
- Serves as the point of contact for program audits and government regulatory staff/agencies (Ohio Department of Aging, Ohio Department of Jobs and Family Services, Ohio Department of Medicaid, Health Plans etc.)
- Direct operations for clinical, compliance, and program development.
- Serve as acting manager in the event of manager absence
- Serve as acting vice president in the event of vice president absence
- Responsible for coordinating manager orientation and clinical development curriculum.
- Provide guidance, education and oversight for medically complex cases
- Develop protocols and standards for case management
- Analyze cases for potential health and safety risks. Provide feedback and support to staff and ensure appropriate actions are taken and follow up is completed
- Respond to emergencies and assist as necessary
- Provide management and supervision to care coordination specialist
- Conduct performance management and development of staff
- Monitor attendance and schedules of staff
EDUCATION, KNOWLEDGE, SKILLS, EXPERIENCE REQUIRED:
- Education: Bachelor’s Degree in nursing, Social Work, Gerontology, Human Relations, or related fields. Master’s Degree preferred.
- Knowledge: Thorough knowledge of program operations in a Medicaid or long-term care environment and/or the aging or disability services network.
- Skills: Excellent leadership, people development, program development, management, problem solving, critical thinking, communication, collaboration and management skills.
- Experience: Must have a broad knowledge of Medicaid programs. Must have at least five years of clinical management experience. Must have at least five years of demonstrated program operations management experience as an administrator or manager in a healthcare, managed care, non-profit or government organization. Must have at least three years of experience administering long term care or community-based programs or services.
- Licensure: LSW, LISW or RN required. RN preferred.