Program Integrity Specialist-Medicaid and Long-Term Care
Core
Ensure Medicaid and Long-Term Care program integrity for the State of Nebraska by acting as a subject matter expert on regulations and setting expectations for Home and Community Based Services (HCBS) providers.
Role type
Program Integrity Specialist (Medicaid and Long-Term Care)
Builds
Internal policy and procedures for HCBS programs
Domain
Public Administration / Healthcare / Human Services
Required skills
Data mining, investigation strategies, policy development, regulatory interpretation, program planning, report writing, stakeholder communication
Preferred skills
Experience with Nebraska Medicaid providers, Medicaid Waiver Services, electronic visit verification system, knowledge of Medicaid federal regulation
Technologies
Electronic visit verification system
Responsibilities
Gather information from regulations to develop internal policy; Conduct data mining and intervention strategies for provider investigations; Ensure HCBS providers use the electronic visit verification system; Research and interpret federal and state laws to formulate policies; Draft and implement program regulations; Write reports and position papers; Explain operational practices and regulations to teammates and providers; Coordinate with other departmental divisions or outside agencies.
Seniority
Mid-level, hands-on IC