What are the responsibilities and job description for the Medicaid Team Lead- Community Care position at Visiting Nurse Health System Inc?
Medicaid Team Lead- Community Care Service Programs
Visiting Nurse Health System (Visiting Nurse) seeks a Medicaid Team Lead (MTL) for Community Care. The MTL directly interfaces with DFACS state representatives across multiple regions in Georgia. Responsibilities include interviewing clients for Medicaid, submitting Medicaid applications and renewals, managing state escalation processes, tracking and analyzing trending data, and providing guidance as Team Lead to the Medicaid Specialist team. VNHS needs a driven individual who can produce results with KPI’s, business analytics and productivity management. This role’s headquarters is at our Hartsfield office in Atlanta, GA 30354.
Serving the Atlanta area for over 75 years, Visiting Nurse is a leading provider of home healthcare, long-term care at home, hospice, and palliative care services, helping patients and their loved ones receive care at home following an illness, surgery, or hospital stay. The ideal candidate lives the Visiting Nurse values of Respect and Integrity, Excellence, Stewardship, and Care.
Our vision is to be the first choice for patients, families, payers, and other healthcare providers when they need home healthcare services. To achieve patient and employee satisfaction scores and clinical outcomes within the top 10 percent of all home healthcare providers in the U.S. To continue to invest in our strong community partnerships, coordinated care solutions, top-performing workforce, and innovative technologies to improve affordability throughout the healthcare continuum. To be a financially strong organization that healthcare professionals prefer to work for. For more information about Visiting Nurse, please visit vnhs.org.
- Serves as the team lead to the Medicaid Specialist team members including monitoring work output, promoting effective working relationships, work efficiently, and maximizing team morale
- Ability to build and develop teams while creating processes and policies
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Maintains highest confidentiality; adheres to all HIPAA guidelines/ regulations
- Under the supervision of the Director of Waiver Operations, assist with developing QA strategies and mechanisms to ensure quality of care and regulatory compliance.
- Conduct audit of charts monthly using the QA tool.
- Interprets CCSP, Medicaid and Medicare policy and procedure as appropriate to the program managed
- Identifies opportunities to improve clinical documentation and works with the Directors of Nursing/CCSP Team Leads and QA to develop appropriate plans of action
- Attends hearings as requested by Director of Waiver Operations providing data and Member records required by the hearing officer
- Uses conflict resolution skills in dealing with clients, family members, providers and peers include the ability to calmly manage a variety of situations while exhibiting self-control, self-awareness and remaining objective at all times.
Do you have....
- Graduate of an accredited Diploma, Associate Degree, or Baccalaureate for a Social Worker.
- CPR Certification (Required)
- 2 years’ experience in social service in home health, hospice, community health, long-term care or geriatric nursing.
- 1- 3 years’ experience in Medicaid.
- 3- 5 years’ management experience and experience in CCSP is required.
- Must have reliable transportation, a GA valid driver's license, and current vehicle insurance
Compensation: $ 53,110.99- 79,666.48
Benefits:
- Medical, Dental, and Vision insurance
- Employee Assistance Program
- Employee Discount
- Flexible Schedule
- Flexible Spending Account (FSA)
- Health Savings Account (HSA)
- Life insurance
- PTO and 9 Holidays
- 403b w/company match
- Pet Insurance
Visiting Nurse is an equal opportunity employer and does not discriminate against qualified applicants based on based on race, color, sex, gender, gender identity, gender expression, religious creed, sexual orientation, pregnancy, national origin, ancestry, age, military and veteran status, marital status, physical or mental disability, protected medical condition, genetic information, reproductive health decision-making, lawful off-duty use of marijuana, any other characteristic protected by law, or any combination of two or more of the characteristics listed here. If you need an accommodation to complete an online application, please contact Visiting Nurse at 404-215-6100.
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Salary : $53,111 - $79,666