Details: Salary Commensurate with experience
103 Lincoln Park
Integrity seeks a Medicaid Quality Manager to join our team. Integrity is a progressive, community-based, non-profit focused on substance abuse rehabilitation. Located primarily in Newark and Hudson County, Integrity delivers behavioral health services to over 3,000 clients each year. Integrity is the largest private non-profit substance abuse provider in the state of New Jersey.
The Medicaid Quality Manager supports the service, billing and clinical requirements of Integrity’s Medicaid funding. S/he works closely with both financial and clinical staff to design and improve underlying processes used to document and bill for Medicaid. The Medicaid Quality Manager acts as the agency expert in Medicaid requirements for Behavioral Health services. S/he provides training, improves/streamlines information flow, reviews client and billing files, recommends improvements and ensures they are implemented.
- Evaluate current clinical documentation practices against Medicaid requirements to identify gaps and propose process improvements
- Design and conduct ongoing training for program directors, counselors and other direct care staff to ensure standards are met.
- Work with agency’s Electronic Health Record team to increase the system’s capability to capture data in a Medicaid funded environment.
- Work with the agency’s Director of Billing Services to improve the Medicaid revenue cycle.
- Perform internal monitoring and propose process improvements.
- Stay abreast of state and federal changes to Medicaid eligible services and help the agency prepare for future changes.
- Guide Integrity’s contracting process with New Jersey Family Care Managed Care Organizations.
- Provide assistance to programs in outreach to Medicaid eligible clients to expand their easy access to addictions treatment and support.
- Bachelor’s Degree, Master’s a plus
- 3-5 Years of experience in Medicaid training, billing implementation and/or quality assurance
- Ability to work in a team environment to provide solutions to problems
- Experience developing and improvement workflow systems.
- Strong understanding of Behavioral Health service delivery - inpatient and outpatient settings
- Knowledge of claim processes and systems
- Ability to respond to a high volume of work and maintain a polite and professional manner at all times. Must demonstrate positive attitude.
Integrity offers a comprehensive benefits package.
Level of Language Proficiency
Fluency in English
Minimum Education Required
How To Apply
Interested candidates should send their resume which must include a cover letter including current salary and why he/she wants to work for Integrity, Inc. to email@example.com. Please indicate Medicaid Quality Manager in the subject line.