What are the responsibilities and job description for the Special Needs Plan (SNP) Administrator position at Viva Health?
VIVA HEALTH, ranked one of the Best Places to Work by Modern Healthcare, is seeking a Special Needs Plan Administrator to join our team in Birmingham, AL!
At VIVA HEALTH, our employees are a part of the communities they serve and proudly partner with members/patients on their healthcare journeys. Come join our team! We offer a great benefits package including 401k, tuition reimbursement for employees and dependents, paid parental leave, and paid day for community service, just to name a few!
The Special Needs Plan (SNP) Administrator is responsible for assisting the Director of Health Services Programs in the coordination, development, administration, and implementation of the SNP requirements in accordance with the Centers for Medicare and Medicaid Services (CMS) guidelines for the Model of Care (MOC). This position is responsible for the submission of the SNP Model of Care, and any Service Area Expansion of services. The SNP Administrator evaluates and monitors progress toward meeting requirements on a continuous basis and identifies any opportunities to improve upon the process. The SNP Administrator works closely with the Quality Improvement, Pharmacy, Provider Services, and Compliance departments to ensure activities required to meet all elements of the MOC are updated on an ongoing basis and meet the established guidelines.
REQUIRED:
- Graduate of an accredited program of nursing or equivalent 2-year degree
- Three to Five years of experience in a clinical setting
- Strong professional level of knowledge and comprehensive clinical assessment skills in the adult population and chronic disease management
- Demonstrate excellent customer service skills through written and verbal communication
- Ability to use Microsoft Office Products such as Word, Excel, and PowerPoint
- Strong professional writing skills related to operations and policy and procedure development
- Ability to be flexible, adaptable, and work effectively in a variety of settings
PREFERRED:
- Current RN, LPN, or SW license in good standing with the State of Alabama in area of practice
- Certified Case Manager
- 3 – 5 years’ experience in Quality Improvement
- Experience with Special Needs Plan or other Chronic Disease Program
- Knowledge of community resources, Medicare, and Medicaid regulations
- Knowledge of CMS or NCQA guidelines governing the Special Needs Program
