QA Provider Relations Coordinator - 2206030

Essential Functions:

• Compiles necessary information and data; collects and reviews current treatment and compliance of service providers with rules and regulations.
• Provides technical assistance to SSA staff in reviewing information related to UI/Major Unusual Incidents.
• Maintain current knowledge of rule, Health and Welfare Alerts and rule changes.
• Maintain annual satisfaction surveys and other satisfaction surveys as compiled. Provide tracking reports, trends, and patterns as requested.
• Maintains provider information on the website, provider portal, constant contacts, and any other provider directory that the County Board maintains.
• Participates in various local/statewide meetings and committee work related to provider requirements, compliance, and other Medicaid issues.
• Performs regular and special compliance reviews in a thorough and timely manner and produces tracking and reports as needed. Complete fraud referrals as needed or requested. Maintain the suspension status of providers and assist DODD with contacting providers under review.
• Facilitates/coordinates provider support meetings and meaningful trainings on pertinent/current topics. Coordinates training in billing procedures and documentation. Maintain training resources and materials to share with providers. Provide direct support to providers with regard to certification/recertification with DODD, billing and service provision. Function as a mediator between providers and County Board staff when needed.
• Participate, facilitate, and/or coordinate meetings/trainings to review delivery of services by Medicaid provider agencies.
• Assists providers, future providers or other stakeholder agencies with additional supports and training to maintain and improve quality supports offered to individuals.
• Assist in agency accreditations and the department’s ongoing quality Improvement initiatives. Provides feedback to departments to improve process for quality improvement.
• Responsible for billing Medicaid Administration (MAC) for funding related to waiver activities.
• Provide technical assistance and training as needed to improve the coordination and delivery of services.
• Review provider documentation for compliance on locally funded contracts.
• Complete PASRR assessments and enter information into the state system.