Medicaid Program Manager Jobs in Virginia (NOW HIRING)

 
JOB DESCRIPTION
MEDICAID PROGRAM COORDINATOR

Primary Function

Manages and coordinates all aspects of the York County School Division's Medicaid School-Based Services Billing Program to ensure accurate, timely, and compliant reimbursement for eligible student services. Oversees Medicaid eligibility coordination, documentation, billing, compliance, reporting, and training activities in accordance with federal, state, and local requirements. Serves as the primary liaison among service providers, finance staff, and external agencies. Provides additional programmatic and administrative support for related student support and outreach initiatives. This is a non-supervisory position.

Minimum Qualifications

• Completion of high school required; completion of business school training, two years of college, or an equivalent combination of education and experience preferred.
• Knowledge of administrative and program support functions.
• Ability to work independently with minimal supervision while maintaining professional decorum.
• Strong organizational skills with the ability to manage detailed information accurately.
• Ability to meet deadlines and work effectively under pressure.
• Proficiency in Microsoft Word, Excel, PowerPoint, Access, and web-based systems.
• Effective written and verbal communication skills.
• Ability to establish and maintain effective working relationships with staff, families, and external agencies.
• Ability to maintain confidentiality and comply with applicable regulations related to student records and Medicaid programs.
• Ability to attend required trainings and meetings as assigned.

Knowledge, Skills and Abilities

• Knowledge of Medicaid School-Based Services programs and reimbursement processes or ability to acquire such knowledge.
• Knowledge of federal, state, and local compliance requirements related to Medicaid billing and reporting.
• Skill in data management, recordkeeping, and documentation.
• Ability to analyze information for accuracy and compliance.
• Ability to prepare reports, claims, and supporting documentation.
• Strong attention to detail.
• Ability to communicate effectively with technical and non-technical individuals.
• Ability to coordinate training and provide guidance to service providers.
• Ability to manage multiple priorities and tasks concurrently.
• Ability to work collaboratively across departments.

Performance Responsibilities

• Coordinates and manages the division's Medicaid School-Based Services Billing Program to ensure compliance with all applicable regulations.
• Collaborates with school administrators, special education staff, related service providers, transportation staff, finance staff, and information technology staff to support Medicaid billing processes.
• Maintains Medicaid eligibility status for students receiving reimbursable services and communicates status updates to providers.
• Uploads verified Medicaid-eligible students to provider caseloads within the Medicaid online billing system.
• Monitors and supports compliance with Medicaid documentation and billing requirements.
• Assists with financial oversight of the Medicaid program, including preparation of payment vouchers, remittance documentation, tracking expenditures, and monitoring reimbursable supplies and services in coordination with Finance staff.
• Supports payroll and reporting activities related to Medicaid administrative claims and cost reporting.
• Accesses student information systems to obtain special education transportation data and parental consent documentation necessary for Medicaid billing.
• Facilitates and tracks licensure of school-based service providers and coordinates licensure reimbursement when applicable.
• Provides training and ongoing support to school-based providers regarding Medicaid billing processes, documentation requirements, and system updates.
• Attends required Medicaid School-Based Services trainings and communicates updates to relevant staff.
• Reviews Individualized Education Programs (IEPs) to identify Medicaid-reimbursable services and assists providers with development of Plans of Care.
• Assists with Medicaid Billing Compliance Reviews, including preparation of required documentation for DMAS.
• Prepares annual Medicaid cost reports and submits quarterly administrative claims for reimbursement.
• Provides data entry, record maintenance, and reporting support related to foster care services, including completion of required state reimbursement reports.
• Assists families with applying for Medicaid and FAMIS programs as needed.
• Provides support to attendance and outreach services by responding to family inquiries and assisting with record maintenance.
• Supports homebound services, homeschooling, McKinney-Vento programming, adult education, and other outreach-related functions as assigned.
• Models nondiscriminatory practices in all activities.
• Performs other duties as assigned.

Position Type: Non-Exempt

Reports to: Grant Accounting Analyst II

Terms of Employment: Twelve months a year. Salary according to School Board Pay Plan.

Evaluation: Performance on this job will be evaluated in accordance with School Board policy and administrative regulations on evaluation of non-licensed personnel.

The York County School Division does not discriminate on the basis of race (Title VI), color, religion, national origin, veteran status, sex, gender (Title IX), age or disability (Section 504), or any other protected class in its educational programs, activities or employment and provides equal access to the Boy Scouts and other designated youth groups. The following positions have been designated to handle inquiries regarding the non-discrimination policies: