Medicaid Manager Jobs (NOW HIRING)

Berkeley County Schools (WV) – Special Education Department, Martinsburg, West Virginia

Job ID: 5844750

Application Deadline: Jul 28, 2026 11:59 PM (Eastern Standard Time)

Posted: Jul 21, 2026 4:00 AM (UTC)

Starting Date: Immediately

Position: Supervisor of Medicaid Compliance and Accountability

Location: Central Office – Multi-Location

Supervisor: Executive Director of Special Education

Salary: Coordinator Index, based on degree and years of experience

Length of Employment: 230 Days – Flexible Schedule

Supervises: District Medicaid processes and assigned program activities; provides functional oversight and guidance to designated personnel

Job Goal: Serve as the district Medicaid Manager, leading participation, compliance, reporting, and continuous improvement for the school‑based Medicaid program.

The supervisor chairs the district Medicaid Team, coordinates representatives from Speech‑Language Pathology, Physical Therapy, Occupational Therapy, School Psychology, Nursing, Transportation, Pre‑K, EPIC/E‑School Docs, Finance, and other departments. The team implements and monitors Medicaid procedures, training, documentation, billing, and compliance activities.

Functions include collaboration with schools, providers, and external agencies to maintain compliance, enhance participation, improve service delivery, and maximize allowable reimbursement.

• Master’s degree in Special Education, Educational Leadership, School Administration, Healthcare Administration, Nursing, or related field is preferred.
• Minimum of three years of experience in special education, school‑based Medicaid, educational administration, healthcare administration, finance, auditing, or regulatory compliance is preferred.
• Knowledge of IDEA, school‑based Medicaid, related services, documentation, billing, reimbursement, and regulatory compliance.
• Ability to analyze data, conduct compliance reviews, develop procedures, identify trends, and implement continuous improvement strategies.
• Strong leadership, organizational, communication, training, problem‑solving, and interpersonal skills.
• Collaborative work with district personnel, families, healthcare providers, consultants, and external agencies.
• Integrity and professional judgment in handling protected student, personnel, medical, and financial information.

• Federal and state Medicaid requirements applicable to school‑based services.
• Individualized Education Programs, related services, procedural safeguards, and IDEA requirements.
• Medicaid documentation, billing, reimbursement, auditing, monitoring, and corrective action processes.
• Medicaid‑eligible services, including related services, nursing, transportation, Targeted Case Management, and others.
• Random Moment Time Study requirements and procedures.
• WVEIS, E‑School Docs, EPIC, and other district‑approved systems.
• Provider licensure, certification, qualification, and enrollment requirements.
• FERPA, HIPAA, Medicaid confidentiality requirements, and Berkeley County Schools policies.

• Act as the district Medicaid Manager and primary contact for schools, departments, providers, administrators, and external agencies.
• Chair and facilitate monthly meetings of the Medicaid Team.
• Coordinate team representatives from relevant departments.
• Lead the team in reviewing participation rates, services, billing trends, training needs, regulations, and audit findings.
• Integrate input on related services, transportation, RMTS, Targeted Case Management, coding, data systems, finance, and billing.
• Communicate the purpose, requirements, and value of school‑based Medicaid and reinforce district expectations for eligible staff.

• Provide district‑wide oversight of Medicaid participation, service delivery, documentation, billing, reimbursement, and compliance.
• Develop, implement, monitor, and update district Medicaid procedures, manuals, handbooks, forms, flowcharts, and guidance.
• Ensure compliance with federal and state Medicaid requirements, IDEA, WVEI, and district policies.
• Conduct internal audits and compliance reviews of provider records, service logs, billing practices, student records, and transportation documentation.
• Develop and implement an annual Medicaid audit schedule for schools, departments, providers, and billing records.
• Coordinate responses to external audits, monitoring visits, program reviews, and documentation requests.
• Develop and monitor corrective action plans and implement recommendations from audits or consultants.
• Ensure Medicaid providers maintain required licenses, certifications, qualifications, credentials, and enrollment status.

• Establish procedures for accurate, consistent data across district systems.
• Use WVEIS, E‑School Docs, EPIC, Medicaid billing systems, and other approved systems to monitor participation, service delivery, documentation, and billing.
• Collect, verify, and report monthly data on student, provider, caseload, consent, participation, service delivery, and billing.
• Monitor RMTS participation, response timelines, and state deadlines.
• Monitor Targeted Case Management for participation, documentation, service delivery, and billing.
• Develop dashboards and performance indicators to monitor participation rates, reimbursement, documentation compliance, claim outcomes, and missed billing opportunities.
• Identify significant changes in billing and participation and recommend corrective actions.
• Provide monthly Medicaid reports to the Superintendent, Chief Financial Officer, and Executive Director of Special Education.

• Review provider schedules, caseloads, and service delivery records to support IEP compliance and efficient staffing.
• Develop and monitor procedures for obtaining, tracking, maintaining, and uploading Medicaid parent consent documentation.
• Develop procedures for addressing missed services, incomplete documentation, scheduling issues, and coaching.
• Monitor district‑wide implementation of Medicaid‑eligible services, including related services, nursing, psychology, audiology, transportation, and others.
• Coordinate with Transportation and Special Education to monitor Medicaid‑eligible transportation services, required documentation, van billing procedures, and reimbursement opportunities.
• Collaborate with administrators, coordinators, supervisors, and providers to resolve service delivery, documentation, staffing, and compliance concerns.
• Offer recommendations and oversight related to contracted providers and outside agencies delivering special education or related services.

• Develop and provide ongoing professional development, in‑service training, written guidance, examples, and technical support related to Medicaid participation, documentation, billing, service delivery, and compliance.
• Establish, train, and support a Medicaid contact at each school.
• Serve as the key district contact for school‑based Medicaid contacts and maintain consistent communication and follow‑up.
• Communicate changes in Medicaid regulations, billing requirements, documentation standards, state guidance, and district procedures to affected personnel.

• Collaborate with Finance and billing personnel to ensure timely, accurate, and compliant submission of Medicaid claims and resolve denied or rejected claims.
• Analyze reimbursement and participation trends, identify missed billing opportunities, forecast Medicaid revenue, and recommend strategies to maximize allowable reimbursement while maintaining compliance.
• Stay current on Medicaid requirements, maintain confidentiality and organized records, support continuous improvement initiatives, and perform other duties assigned by the Executive Director of Special Education.

• Increased participation in eligible Medicaid programs and services.
• Improved Medicaid reimbursement.
• Enhanced compliance with Medicaid regulations and district procedures.
• Reduced audit findings, documentation deficiencies, and corrective actions.
• Improved provider participation and timely documentation.
• Increased accuracy across district data and billing systems.
• Improved RMTS and Targeted Case Management participation.
• Reduced claim denials and missed billing opportunities.
• Effective monthly operation of the district Medicaid Team.
• Timely and accurate monthly reporting to district leadership.
• Effective communication and support through school‑based Medicaid contacts.
• Improved fiscal stewardship and sustainability of the district Medicaid program.
• Evidence that eligible students receive required services in accordance with their Individualized Education Programs.

Position Type: Full‑Time

• Citizenship, residency, or work visa required.

• Lee‑Dorah Wokpara, Recruiter/Talent Management Coordinator
• 1453 Winchester Ave
• Berkeley Co. Schools – HR Dept.
• Martinsburg, West Virginia 25405
• Phone: 304‑267‑3500
• Fax: 304‑267‑3524
• Email: lwokpara@k12.wv.us