Medicaid Implementation and Management Specialist

WHO WE ARE:

Annually serving over 1,400 youth and families, Lawrence Hall is a community-based organization committed to helping Chicago's youth, families, and communities heal from the adverse effects of childhood trauma. For more than 150 years, Lawrence Hall has been delivering high-quality care throughout the Chicago metropolitan area and is a statewide leader in highly effective, evidence-based, and innovative therapeutic treatment. Their core programs-Child and Family Treatment Center, Therapeutic Day School, Creative Therapies, Foster Care, Transitional/Independent Living Program, Workforce Development, and Community Wellness-have met the changing and complex needs of youth and families by not only becoming more community based, but also by developing more preventative programs that help curb violence in Chicago's communities.

ESSENTIAL FUNCTIONS:

Reports directly to the Chief Program Officer. Serves as the agency's coordinator, trainer, and compliance monitor for all Medicaid services and programs. The Medicaid Implementation and

Management Specialist stays current with the latest DCFS, state, and federal guidelines as it pertains to Medicaid Rule 132 and 140 services. The Medicaid Implementation and Management Specialist is responsible for championing compliance with Medicaid implementation and documentation across all levels of service and in all agency programs. This role works collaboratively with agency leadership to support Lawrence Hall in achieving both clinical and financial performance indicators related to Medicaid. This position is the lead person responsible for collecting and reporting data related to Medicaid Part 132 services that are rendered through the agency's various programs. Requires a basic understanding of the young people/customers served by Lawrence Hall and participation in basic trauma training with the ability to utilize that training when interacting with young people/customers of the agency.

Must be able to effectively use verbal intervention skills with individuals six (6) through twenty-one (21) years of age.

Lawrence Hall fosters a culture built upon four core values: Respect, Empowerment, Safety, and Teamwork. These values are deeply embedded within our organization's philosophy of trauma-informed care and directly influence every position.

JOB RESPONSIBILITIES:

• Coordinate and monitor the implementation of the Medicaid compliance program
• Implement written policies, procedures, and lead provider team(s) in Medicaid compliance
• Enforce standards through training, quality monitoring, employee remediation plans, and progressive discipline procedures (in collaboration with Program/Department Vice Presidents)
• Provides in-person modeling of effective documentation expectations. This may include time spent in the residential milieu.
• Provide regular Medicaid documentation training to employees which increase employee's understanding of documentation in the agency's electronic health record system, as well as their understanding of Medicaid services and compliant documentation.
• Provide regular feedback regarding documentation and productivity both individually and in team meetings.
• Work collaboratively with the Business Office, IT, and Programs to align Medicaid financial goals with clinical best practice.
• Remains abreast of latest trends in the industry as it relates to Medicaid production in Lawrence Hall's core programs. This includes participation in the IM CANS Workgroup.
• Conduct periodic compliance audits and work with administrators to develop response plans
• Assists with agency's Utilization Reviews when requested
• Conduct investigations related to Medicaid or service documentation fraud
• Work with administrative team as the lead steward to coordinate and plan for Medicaid/IPI site visits and reviews of Rule 132 and Rule 140.
• Maintain and update Medicaid documentation templates with the latest compliance standards
• Work in conjunction with program Vice President and designated Clinical Supervisor/Manager to track completion and compliance of Medicaid documentation such as Integrated Assessment, Treatment Planning and Illinois Medicaid Child Assessment of Needs and Strengths
• Produce compliance reports on a pre-determined schedule
• Monitor implementation of Medicaid services in unit schedules through documentation review and on-site observation of services
• Attend IPI/DCFS/HFS or other external trainings/committees on Medicaid
• Uses active and reflective listening skills and affirmations to demonstrate respect and empathy, avoiding negative and derogatory labels that foster disrespect
• Understand that behaviors, responses, attitudes, and emotions are a collection of survival skills often developed in response to traumatic experiences
• Maintain confidentiality of employees, volunteers, and program participants to provide a safe environment
• All employees are required to complete and maintain certifications in all trainings relevant to their role. This position specifically mandates completion of Therapeutic Crisis Intervention (TCI). Subsequent recertification is required every six months. Successful completion of these trainings is essential, but equally important is the consistent application of these skills in daily work.
• Attend at least two trainings related to being trauma informed in a twelve month period
• Ability to work effectively with program participants and family members, employees and vendors in a culturally diverse environment to support healing and recovery
• Maintains electronic calendar to provide accounting for daily activities and provides permissions for viewing to the appropriate individuals
• Adapt work schedules as needed to meet agency needs and perform other duties as assigned.

QUALIFICATIONS:

• Minimum of a bachelor's degree, in psychology, counseling, social worker or another human services field. Master's degree with an LSW or LPC preferred
• Strong solution-focused strategic thinking skills and interpersonal skills with the ability to align people related strategies and recommendations for meeting Medicaid objectives and goals
• Detail-oriented
• Adaptable and flexible style of collaborating with key stakeholders
• Good written and verbal communication skills
• Leadership experience in the Medicaid healthcare arena is preferable
• Assertive leader who is comfortable working in a multi-disciplinary team environment and across various agency programs
• Adept at change management and implementing procedures
• Knowledge of childhood trauma and prior experience working in settings with youth and families that have been exposed to trauma or experiencing traumatic stress preferred
• Knowledge of youth development, adolescent issues, positive youth development/strength-based approach preferred
• Ability to travel between multiple Lawrence Hall offices across Chicago.
• Ability to work a flexible schedule to support training and Medicaid production needs of the programs
• A clean driving record, valid Illinois driver's license, personal vehicle or access to a vehicle, and proof of auto insurance.
• Ability to pass background, drug screen, with no history of child abuse or neglect

Benefits and Perks that Support You

• Time Off Benefits (PTO): Employees receive an average of 17-25 days of PTO, including vacation, paid leave, and sick time, in addition to 9 paid holidays.
• Health Insurance: Comprehensive medical, dental, and vision plans are available for employees, spouses/domestic partners, and child dependents.
• Wellness Reimbursement: Employees can receive up to $20 per month towards wellness-related subscriptions/memberships.
• Retirement Savings: Our 401(k) plan includes a 100% employer match on contributions up to 3% after one year of service.
• Supplemental Insurance: Coverage options include Critical Illness, Accident Insurance, and Short-Term & Long-Term Disability for employees and their families.
• Life & AD&D Insurance: Full-time employees receive term life insurance equal to twice their salary at no cost.
• Commuter Benefits: Pre-tax options are available to help cover parking and transit expenses.
• Employee Assistance Program (EAP): A free and confidential resource providing support for personal and work-related challenges.
• Employee Referral Program: Employees can earn up to $1,500 for referring successful candidates.
• Tuition & Loan Assistance: Lawrence Hall is a qualifying employer for the Public Service Loan Forgiveness Program.

This position meets the FLSA requirements for Exempt.

Job descriptions are not intended and should not be construed to be all-inclusive lists of all responsibilities, skills, efforts or working conditions associated with a job. While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add or remove duties from particular jobs and to assign other duties as necessary.

Equal Opportunity Employer M/F/D/V

Salary : $45,000 - $50,000