Medicaid Project Manager

Description
NaphCare has an excellent opportunity for a Medicaid Project Manager to join our team.
This is a full-time position. No Visa sponsorships or transfers.
This is an excellent opportunity for someone with a history of clinical and technical implementations of processes surrounding Medicaid coding, billing, and claims. The Medicaid Project Manager is responsible for the implementation and management of Medicaid-related projects, primarily involving the Waiver 1115 initiative for justice involved individuals. This role includes research and understanding of state-specific Medicaid Program requirements, implementation of suitable workflows to meet these requirements, overall project management/reporting, and project success. The Medicaid Project Manager will work across NaphCare's clinical, billing, and technical teams alongside our partner facilities to implement the program. This position reports to our VP of Claims Administration.
The Project Manager is responsible for the overall Implementation and Project Management of the Waiver 1115 Program for Justice Involved Individuals. This specifically includes:

• Complete understanding of the Waiver 1115 Program.
• Working with partner facilities on the Medicaid Facility Registration Process.
• Developing requirements for software changes needed to implement the program's requirements.
• Supporting implementation of new clinical workflows to capture pertinent information.
• Implementing a billing process aligned with Waiver 1115 requirements.
• Establishing and Maintaining a relationship with state Medicaid.

ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function which may be performed at the job level.

• Manage high-visibility, strategically important projects as requested by Company Leadership and specifically related to implementation of Medicaid processes.
• Planning and direction of project work effort including feasibility, resource allocation and budget.
• Coordination with partner agency executives and other related entities including regional and federal partners.
• Planning and Evaluating the effectiveness of processes related to program implementation.
• Achieving program objectives while complying with federal regulations.
• Assess organizational risks and communicate issues and recommended resolution strategies.
• Monitor project timelines, resources, and budget.
• Ensure project milestones and deliverables are met with supporting status reports.
• Establish and maintain the Resource Management and Staffing Plan.

Qualifications
Preference is given to applicants who possess a Bachelor's degree in a healthcare or related field of study or who maintain any of the following certifications: Project Management Professional (PMP), Medi-Cal Assistor Program. In addition, the following knowledge set should be possessed by the successfully applicant.

• Knowledge of Medicaid and processes around the Waiver 1115 Program.
• Knowledge of Clinical workflows supporting Medicaid billing.
• Knowledge of EHR software and utilization.
• Knowledge of Medicaid billing codes, and claim submission processes.
• Oral and written communication skills with ability to communicate with technical and non-technical audiences.
• Knowledge of and ability to organize diverse tasks and requests.
• Knowledge and effective use of Microsoft Suite including Word, Excel, and PowerPoint.
• Knowledge and effective use of Microsoft SharePoint or other document management repositories/tools.
• Knowledge of system or process assessments or improvement.
• Knowledge of business process documentation and redesign and documenting business process flows.

Outstanding Benefits Package:
NaphCare offers competitive benefits, including health, prescription, dental, Employment Assistance Program (EAP) services, vision and 401(k). NaphCare offers term life insurance at no cost to the employee and provides PTO, paid holidays and an array of voluntary benefits. Employees enrolled in our health insurance program receive prescriptions free of charge when filled at our in-house pharmacy or mail order program.
If you want a career that will make a difference, choose the company that is different. NaphCare professionals are important partners of the NaphCare family, working together to provide quality care in a rewarding work environment. We care about making a difference in the lives of others.
Come learn correctional healthcare as you use our cutting-edge resources, including our award-winning electronic health record system.
At NaphCare, we believe in innovating to improve lives. We partner with local, state and federal government agencies to provide innovative healthcare, technology and administrative solutions for complex problems within the correctional and justice systems. Our success has always been due to our people and our commitment to treating every patient with dignity. We are mission-driven with a singular aim of improving lives through caring health care solutions provided in an environment of respect. United by this belief, we work as a team to improve each and every life we touch. Join our team of compassionate trailblazers who are dedicated to making a difference.
Equal Opportunity Employer: disability/veteran