Purpose of Your Job Position
As a Consulate Health Care Medicaid Support Field Manager, you are entrusted with the responsibility of carrying out your daily tasks and assigned duties while demonstrating Consulate’s Core Values of Compassion, Honesty, Integrity, Respect and Passion.
You are expected to provide innovative, responsible results with the creation and implementation of new ideas and concepts that continually improve systems and processes to achieve superior results.
The primary purpose of your job position is to manage the Florida Medicaid authorization process for an assigned group of Skilled Nursing Facilities (SNF) through training, implementation of best practices and assistance to obtain authorizations, including follow-up of outstanding accounts receivable.
As Medicaid Support Field Manager, you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties.
Responsible for guiding and assisting the care center teams to obtain Medicaid authorizations, including resolution of outstanding accounts receivable, this positions works closely with the care center teams, regional teams and Central Business Office (CBO) to resolve outstanding Medicaid authorization issues.
This job description does not list all the duties of the job. You may be asked by supervisors or managers to perform other duties.
You will be evaluated in part based upon your performance of the tasks listed in this job description. The employer has the right to revise this job description at any time, for any reason.
Duties and Responsibilities
Responsible for leading the effort to guide, train and assist the care center Business Office Managers (BOM) with the Florida Medicaid authorization requirements and resolution of outstanding accounts receivable.
Serve as the subject matter expert for the Florida Medicaid authorization process for Managed Medical Assistance (MMA) plans and conversion to the Long Term Care (LTC) plan.
Identify root causes for process break-downs and develops solutions to address problem areas by partnering closely with the Regional Directors of Business Office Services (RDBOS), BOMs and CBO.
Perform daily review of accounts newly registered with FL MMA plans to validate accuracy of the plan selected and completeness of supporting documents required to obtain authorizations.
Monitor the FL Medicaid MMA accounts approaching the 120 benefit limit and pursue resolution with the care center teams prior to reaching the 120 day limit.
Prepares routine reports detailing the status of the outstanding Florida Medicaid authorizations.
Work closely with the care centers to obtain authorizations timely, including hands-on assistance to resolve outstanding authorizations and conversion to the long term payer.
Assists with special projects as needed.
operate within specific policy guidelines.
Comply with all safety policies, practices and procedures. Report all unsafe activities to supervisor and / or Human Resources.
Participate in proactive team efforts to achieve departmental and company goals.
Provide leadership to others through example and sharing of knowledge / skill.
Embrace Consulate Health Care’s five core values of compassion, honesty, integrity, respect and passion, and incorporate them into one’s daily job function.
All other duties as assigned.
Education / Experience
Bachelor’s degree from a four-year college or university; or two years related experience and / or training; or an equivalent combination of education and experience.
Must possess a minimum of two (2) years experience in a Skilled Nursing Facility business office setting with specific billing / collecting experience preferably with Florida Medicaid.
Experience with the Florida Medicaid portal with a solid understanding of the information is preferred.
Point Click Care (PCC) billing system experience preferred.
National Data Care Resident Funds Management System (RFMS) experience preferred.
Experience using Excel, Power point, and Word.
Ability to read, analyze and interpret complex documents. Ability to respond effectively to sensitive inquiries and complaints.
Ability to write speeches and articles using original or innovative techniques or style. Ability to make effective and persuasive speeches and presentations to top management, public groups and boards of directors.
Ability to apply concepts such as fractions, percentages, ratios and proportions to practical situations.
Proficient personal computer skills to include electronic mail, record keeping, routine database activity, word processing, spreadsheet applications, graphics, etc.
Handle multiple projects simultaneously.