What are the responsibilities and job description for the Medicaid Quality Assurance Analyst position at Senan Group LLC?
Job Summary
We are seeking a detail-oriented individual to serve as a consultant for the MSDE to support implementation of Maryland’s AW program and School-Based Medicaid Program.
Term of Contract
A single (or Multiple) contract will be awarded to the Bidder that best meets the needs of the evaluation criteria. The anticipated term of the contract resulting from this solicitation shall begin on or about February 1, 2025 and terminate on January 31, 2026.
Place of Work
Work will be completed at the Maryland State Department of Education, Nancy S. Grasmick Building, 200 W. Baltimore Street, Baltimore, Maryland 21201. Hybrid work schedule is available.
Mandatory Requirements
The Bidder shall meet the following minimum requirements:
- A. Essential Requirements
1) Minimum 3 years’ experience in monitoring and providing technical assistance to Medicaid Providers regarding COMAR 10.09.36, 10.09.50, 10.09.52, 10.09.56, COMAR 10.09.25, and/or 10.09.40.
2) Minimum 3 years’ work experience with Maryland’s Autism Waiver, including knowledge of and expertise in Autism Waiver services and provider qualifications.
3) Knowledge of State and federal requirements for health-related services under the IDEA (Part B and C) through demonstrated experience working for a state or LEA for a minimum of 3 years.
- B. Education Requirements 1) Must possess a master’s degree or higher in education or a human service field from an accredited college or university
Responsibilities
Assist the PIMMT with monitoring AW provider agencies and the IMMT with monitoring school-based Medicaid services, including AW service coordination. Ensure compliance with COMAR and federal Medicaid requirements.
Examine, analyze, track, and interpret payments to Medicaid providers, documentation to support paid claims, and provider qualifications. Examine monitoring data, identify and report discrepancies that could lead to high-risk COMAR violations, prepare reports, and issue/review Corrective Action Plans (CAPs) as assigned.
- Coordinate the dissemination of information regarding the AW provider application process, assist AW prospective providers and existing providers wishing to expand services through the application process and collaborate with MDH to approve AW providers.
Conduct AW prospective provider Statewide workshops on a quarterly basis, provide technical assistance, coordinate and lead structured interviews, and conduct site visits upon request.
- Review and analyze data in AW, Medicaid, and school-based reporting structures, i.e.: MA Grants database, Maryland Online IEP (MOIEP), Special Services Information System (SSIS), local Medicaid or IEP databases, AW Online Databases, AW performance measures, and MOVE IT secure transfer system.
- Recommend revision to rules, regulations, and procedures to support the expansion of the AW, and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for school-based services; for example, changes to COMAR 10.09.52 and 10.09.56. Provide training and technical assistance as needed with policy interpretation and agency collaboration in support of partnerships with the MDH, Medicaid providers, and community stakeholders.
- Assist the Division in review of grants and providing technical assistance related to Local Application for Federal Funds (LAFF); Intergovernmental Transfer (IGT); Maryland’s Blueprint; Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit; Maryland Children’s Health Program (MCHP); and the AW as requested.
Job Types: Full-time, Contract, Temporary
Pay: $36.50 - $40.00 per hour
Expected hours: 20 per week
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
Work Location: In person
Salary : $37 - $40
