Clinical Medicaid Specialist

Description

Travel to various Wallick Senior Living communities throughout Ohio is required for this position. Preference will be given to candidates with substantial experience in the Medicaid Waiver program and familiarity with the Ohio Department of Aging, particularly in relation to senior living services.

Qualified candidates must hold an active LPN license or higher, or be a licensed social worker (LSW) in the state of Ohio.

Wallick Mission: Opening doors to homes, opportunities, and hope.

Wallick Values: Our Values flow directly from our Mission and set the expectation for how all associates work together. These values are:

Care

Character

Collaboration Position Summary: In accordance with Wallick Mission and Values, Clinical Medicaid Specialist will focus on managing Medicaid Waiver consumers and ensuring compliance with current regulations and guidelines.

Qualifications Required:

LPN – must have a current Ohio nursing license with 3 to 5 years’ experience

Prior work experience with Ohio Medicaid Waiver recipients

Must demonstrate a high level of independence, responsibility, and accountability for goal achievement.

Ability to speak and write effectively to present information, solutions, and benefits.

Adeptness to articulate company products, services, solutions and value to prospects and professional referral partners.

Proficient in researching data, analyzing, and completing all reports.

Demonstrates exceptional Customer Service skills. Licenses/Certifications/Registrations: Ohio Nursing License and/or Licensed Social Worker, preferred. Valid Driver’s License is required.

Functions and Responsibilities:

Works closely with Executive Directors, Senior Living Advisors, and Directors of Care for Wallick’s Columbus, Ohio Assisted Living and Memory Care communities to complete necessary requirements for all of the Wallick Senior Living Medicaid Waiver consumers.

Prepares each community for annual Structural Compliance review

Work closely with Public Consulting Group through Ohio Department of Aging to ensure all requested information is submitted timely.

Ensure assessment tool is completed within 48 hours of admission to the community and/or transition to the Medicaid Waiver Program

Ensures annual and quarterly assessments are completed timely for all of the Medicaid Waiver consumers

Collaborates with the Director of Care to ensure all required notifications are communicated to the Medicaid Waiver case managers within 24 hours

Works with the Human Resource Coordinators and Director of Care to ensure all associates have completed Home Community Based Setting training upon hire and annually

Interprets and implements Wallick Senior Living Management and Medicaid Waiver policies.

Stays up to date with changes in policies or regulations issued by Ohio Department of Aging

Develop relationship with Provider Relations specialist in each county where Wallick Senior Living operates through Ohio Department of Aging to assist prospects, or current residents successfully navigate approval and recertification for the Medicaid Waiver Program.

Work closely with Company Medicaid Specialist to obtain service authorizations for Medicaid Consumers Physical Demands: Position requires work to be performed in an office setting. Extensive use of a computer, Keyboard, and mouse; requires talking, seeing, and hearing. Must be able to work in a fast-paced environment.

Work Environment: Work takes place in an office setting with moderate noise levels. Consistent travel around Ohio region will be required.

Full Time