General Definition of Work
This position is responsible for the administrative and technical supervision of the Medicaid supervisors and/or lead workers who have primary responsibility for the Medicaid Program including Family and Children’s Medicaid, Adult Medicaid, Long-Term Care, Non-Emergency Transportation and Program Integrity. The Long-Term Care program is characterized by a greater variety and complexity of guidelines, potential financial loss to the agency, client, or community, and has a greater impact upon the health status of the client. This position may be responsible for other, smaller program areas as needs change. The employee reports to the Economic Services Program Administrator.
This position is responsible for the work of the Medicaid division and manages the Medicaid supervisor team. These teams are comprised of caseworkers involved in the intake, processing, and review functions. The objectives of the Medicaid Program are generally stable, however, there are shifting emphases about how work is completed due to the continual changes in rules, regulations, policies, and procedures in the program.
Employees’ work is reviewed after the fact, generally through an analysis of quality assurance and other relevant reports. Work is performed independently but this position would consult with the Program Administrator and Director on major policy changes or complex decisions.
Qualification Requirement
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skills and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Functions
• Plans the short and long-range work operations, priorities, and goals within the units and/or sub-units supervised.
• Meets with supervisors to develop goals and priorities for the teams on an annual basis.
• Serves as a member of the agency management team and provides input into setting organizational goals and priorities on an annual basis.
• Oversees the Medicaid Program Supervisors who assign and balance workloads within the unit and/or sub-units and coordinate overall workflow.
• Develops procedures and adjusts work between units. At times, this may require significant changes in personnel assignments, staffing, and organizational design to assure that the work is being performed in an efficient manner.
• Prepares needs analysis and justification reflecting trends in utilization of the Medicaid program. This could include assessing and projecting staffing needs, technology needs, and/or equipment/supplies. These requests are submitted in writing to the Economic Services Program Administrator and DSS Director.
• Oversees the Continuous Quality Improvement for the Medicaid Program comprised of training/onboarding new employees, ongoing training and education of case workers and supervisors, second party reviews, and all program improvement processes to ensure appropriate preparation and performance of quality work. This may involve assessing needs and identifying resources for on-the-job training.
• Ensures that employees adhere to Federal and State policies and standards about the quality of work required.
• Utilizes available data, reports, and input from Medicaid supervisors in evaluating the overall performance of individual supervisors and the overall program.
• Counsels supervisors regarding performance and grievance policies and may issue disciplinary actions in consultation with the Economic Services Program Administrator. Employees make recommendations on dismissals to the DSS Director.
• Evaluates staff performance and may make staffing reassignments in consultation with the Economic Services Program Administrator.
• Interviews applicants and makes hiring recommendations to the Economic Services Program Administrator and DSS Director.
• Refers to all applicable policies, procedures, and NC DHHS communications required to complete eligibility determination processes.
• Serves on a shelter team during hurricanes, storms, and other disasters as determined by Emergency Management.
• Performs other duties as assigned.
Knowledge, Skills, and Abilities
• Thorough knowledge of the needs, problems, and barriers that people accessing economic services programs face.
• Thorough knowledge of all Medicaid Programs including policies, forms, and documents used in determining eligibility.
• Considerable knowledge of all agency and community programs and services which could affect the client/applicant.
• Considerable knowledge of the budget and planning process.
• Thorough knowledge of leadership and management skills.
• Ability to organize, direct, instruct and lead the Medicaid team.
• Ability to assess needs and plan for future requirements.
• Ability to read, analyze, and interpret rules, regulations, and procedures.
• Good mathematical reasoning and computational skills.
• Ability to present information and communicate orally and in writing to supervisors, case workers, other agency employees, public officials, and the community.
• Ability to adapt to policy and practice changes.
• Ability to plan and evaluate the services of the Medicaid Program, including to instruct and evaluate the work of lower-level employees.
• Ability to train employees in new and existing rules, regulations, policies, and procedures.
• Ability to perform work using local and state technology systems including NCFAST, Northwoods, iiReception, Microsoft Office, web browsers, and other commonly used electronic programs.
• Skill in maintaining a calm disposition in a variety of situations and maintaining confidentiality.
• Ability to keep records.
• Ability to perform and organize work independently.
• Ability to work with a diverse group of individuals and provide equitable treatment to all.
• Ability to establish and maintain effective working relationships with county officials, employees, associates, community groups and the public.
Education and Experience
Two years of supervisory experience, at least one of which must have been in an economic or family services program and preferably one year of experience in an economic services program; or an equivalent combination of training and experience.
Physical Requirements
This work requires the frequent exertion of up to 10 pounds of force and occasional exertion of up to 25 pounds of force; work regularly requires sitting, speaking, hearing, using hands to finger, handling, feeling, reaching with hand and arms and repetitive motions, frequently requires walking and occasionally requires standing, stooping, kneeling, crouching, crawling, pushing, pulling and lifting; work has standard vision requirements; work requires vocal communication to express or exchange ideas by means of spoken word; work requires hearing to perceive information at normal spoken levels; work requires preparing and analyzing written or computer data, using measuring devices, operating motor vehicles or equipment and observing general surroundings and activities; work occasionally requires exposure to outdoor weather conditions; work is generally in a moderately quiet location (e.g. business office).
Special Requirements
None.