OPEN POSITIONS
Medicaid Waiver Program Manager
REQUIREMENTS
Location: Indianapolis, Indiana – this position is a hybrid position but needs to be located in central Indiana to be onsite with partners as needed.
Summit Managed Solutions partners with healthcare organizations to help them solve their most complex problems. Part strategy consulting, part tech-enabled professional services, our team is a diverse mix of experienced problem solvers who work with partners to create innovative solutions with enduring value.
JOB SUMMARY
The Medicaid Waiver Modifications Program Manager helps to lead the Medicaid Waiver Home and Vehicle Modification Program to meet the needs of members receiving the Home and Community Based Services (HCBS) PathWays Waiver. This waiver service is intended to allow members to age in place by removing barriers to habitability and create accommodation such as ADA and/or safety accommodations. This will require detailed coordination with the State of Indiana, members and caregivers, care/service coordinators, and providers completing the home/vehicle modification for members. The role will be responsible for coordinating the collection of data and program outcomes for a compelling story to highlight increased community engagement, removal of barriers to care and services and programs offered to members resulting in improved quality outcomes.
We are seeking an individual who exhibits a high-level of professionalism, a passion for innovation, and a business style that is scrappy, strategic, creative, team-oriented, hands-on, and collaborative.
What You'll Do:
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Act as the primary lead for the Medicaid Waiver Modification team, collaborating with the care/service coordination team and leaders, provider relations, external providers, etc.
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Assist the Service Coordination team in implementing Medicaid Waiver modification projects and strategies.
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Monitor and ensure compliance with Medicaid regulations and policies, specifically the Pathways Medicaid Waiver Home and Vehicle Modification benefit.
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Lead process improvements that enable efficient workflows for internal teams, while maintaining state compliance and external provider relationships
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Complete initial reviews of modification requests for medical necessity, functional need and eligibility.
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Serve as a primary point of contact for providers on program-related issues.
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Implement processes that allow for efficient coordination and implementation of waiver services and modifications to members
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Coordinate with internal teams to ensure timely responses to provider and member inquiries.
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Prepare and analyze reports related to program performance and compliance.
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Support the training and education of providers on Medicaid program changes and requirements related to home and vehicle modifications.
What You'll Need:
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Requires a Bachelor’s degree in human services, such as Social Work, Psychology, Sociology, or Nursing preferred.
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A minimum of 3 years of experience in healthcare program management is required, specifically in Medicaid or the Medicaid Waiver, or any combination of education and experience which provides an equivalent background.
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Strong knowledge of Medicaid Waiver regulations and compliance requirements.
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Certified Aging in Place Certification (preferred) or has ability to obtain within first six months of employment
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Program Management experience preferred with the ability to manage competing priorities and projects
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Excellent oral, written, and interpersonal communication skills.
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Strong problem-solving, facilitation, and analytical skills.
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Skillful communicator who is comfortable, effective, and influential in meetings with senior management teams
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Self-starter who can thrive in an unstructured and collaborative team environment
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Ability to be onsite with partners in Indianapolis as needed
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Will be required to travel to community partner locations in Indiana
What we offer:
We offer a competitive salary and benefits package, including unlimited PTO to encourage a healthy work-life balance, a company-funded Personal Giving Account for philanthropy at your discretion, and opportunities for professional development and growth.
If you are passionate about making a positive impact in healthcare, we encourage you to apply and become part of our dedicated team.
WHAT WE OFFER
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Competitive salary plus bonus plan
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Medical, dental & vision Insurance with employer HSA contribution
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Company paid STD/LTD and Life Insurance
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Unlimited PTO plan to encourage a healthy work - life balance
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Paid company holidays
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401k with company contribution
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Company funded Personal Giving Account for philanthropy at your discretion
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Monthly technology stipend to help cover additional working expenses
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A fun, collaborative, entrepreneurial environment with support from empathetic leaders
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The opportunity to create, build and grow innovative solutions with world class partners
WHAT WE VALUE
WE TAKE INITIATIVE
We have a bias for action. We make decisions with imperfect information and quickly move forward. We are comfortable with discomfort. We learn, we iterate, and we progress.
WE IMPACT
We have exceptionally high standards and strive to add value through all interactions. We seek, uncover, and speak truth. We measure our success in terms of what we build for partners.
WE INNOVATE
We dream big and we lead through vision. We challenge the status quo and push boundaries. We’re optimists who ignite positive transformations.
ABOUT INDIANA MEDICAID
Medicaid is a health program that provides insurance and benefits for specific populations in the US. The Federal government establishes general guidelines for the administration of Medicaid benefits. Individual states are charged with administering Medicaid so eligibility requirements and the type and scope of services provided can vary by state.
In Indiana, there are 4 main Medicaid programs: Healthy Indiana Plan (HIP), Hoosier Healthwise (HHW), Hoosier Care Connect (HCC), and PathWays. HIP covers Indiana residents ages 19 to 64 who meet specific income levels. HHW covers children up to age 19 and pregnant women. HCC covers individuals who are aged 65 years and older, blind, or disabled and who are also not eligible for Medicare. PathWays will launch in 2024 and covers Hoosiers aged 60 and over who receive Medicaid (or Medicaid and Medicare) benefits.
The state of Indiana contracts the administration of its Medicaid programs (a term known as Managed Care) to insurance companies like Elevance Health (formerly known as Anthem), Humana, CareSource, MDwise, UnitedHealthcare, and others. These insurance companies are responsible for ensuring the care of their members and do way more than just process claims and provide a network of doctors and hospitals. These companies also ensure members have reliable transportation to appointments, have access to healthy food, educate youth on the importance of annual physicals, provide nurse case managers to members with chronic illnesses, provide member resources for stable housing, convene events and celebrations in communities, collaborate with professional sports teams to raise awareness of health issues, coordinate in-home care, deliver dental hygiene kits to churches, implement telemedicine solutions to help those living in rural areas, guide first-time-mothers through their pregnancy journey, and the list goes on!
EQUAL OPPORTUNITY EMPLOYER
Summit Managed Solutions is an equal opportunity employer, and we value diversity at our company. We do not just accept diverse backgrounds, we celebrate them. Our company, the work we do, and our partners benefit from the value of a diverse team. No team member's value lies alone in their diversity, and because we value diversity so highly, we reiterate that all hiring and employment decisions are made on merit, performance, competence, and business needs. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.