Coordinator for Medicaid

To coordinate nursing services for students and staff in the Gadsden Independent School District. Coordinate, implement, and manage the Medicaid School Health Program (MSBS). Provide training to all nursing, special education staff, and others as required regarding reimbursable services. Assist the Director of Nursing and Health Services with the budget planning and utilization of funds that are generated annually through the MSBS program. Coordinate outreach services for uninsured and under insured students.

ESSENTIAL DUTIES AND RESPONSIBILITIES

include the following and other duties may be assigned: Compliance and Collaboration with New Mexico Human Services Department Health

• Medical Assistance Division School Health
• Medicaid School Health Program (MSBS).

Assure compliance with all Federal and State laws and mandates required by the MSBS program. Ensure district Medicaid documentation complies with all Federal and State laws and mandates required by the MSBS program. Monitor, prepare and submit District, State and Federal reports related to MSBS. Attend and participate in all meetings and trainings as required by NMHSD

• MSBS. Works with community agencies as needed to optimize the MSBS. Collaboration and Coordination with Nursing, Special Education, and Educational staff and School District Administrators. Consults with the New Mexico Human Services Department Health
• Medical Assistance Division School Health Office, school district administrators, and other health care professionals to establish and revise policies, procedures, and programs specific to the Management of Medicaid in the schools. Prepare written and oral reports for school district administrators and state agencies as requested or required by the NMHSD
• MSBS Program.

Serve on district wide committees as required. Participates as a team member sharing information and resources as appropriate Budget and Resource Responsibility Establish and lead a committee to review and assess the use of Medicaid funds in the schools. Monitor Medicaid budget to ensure Medicaid expenditure is health related and an appropriate use of the funds. Monitor annual Medicaid in the Schools budget and expenditures, process requisitions, and purchase orders not to exceed prescribed limits. Maintain all records and documentation as prescribed by the MSBS program and district for review and audit purposes. Training and Support Services Identify training needs for health service providers, district administrators, and educational staff as related to the MSBS. Facilitate, organize, and/or provide training to school district staff and administrators related to the MSBS Program. Act as a resource person for the MSBS program Medicaid Student Services Identify Medicaid eligible students on a monthly basis. Monitor billable health services provided by all district health care providers who are qualified health service providers. Perform outreach activities to assist underinsured and uninsured students with accessing health insurance and services. Maintain database to track all providers, students, and Medicaid billable health services. Maintain files and documentation for the MSBS program. Track certifications and licenses of school health providers and submitted to 3 rd party billing agency. Maintains student and employee confidentiality. Other Duties As Assigned Other duties as assigned by immediate supervisor or district administrative staff. Promote and follow district policies and procedures.

SUPERVISORY RESPONSIBILITIES

Directly supervise the Medicaid Clerk/Secretary/Specialist to ensure compliance with the district and MSBS guidelines and regulations. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION and/or

EXPERIENCE

Degree in a Related Field Three years experience related to Medicaid Computer experience: Microsoft Office (Word, Excel Data Base Management) Outlook

LANGUAGE SKILLS

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public. Ability to understand documents, define problems and draw valid conclusions. Interpersonal skills to coordinate and collaborate.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Must be able to compare, analyze, communicate, coordinate, instruct, synthesize, compute, evaluate, compile, negotiate, deal with problems and manage multiple priorities.

CERTIFICATES, LICENSES, REGISTRATIONS

None required with the exception of PED mandated background check.

PHYSICAL/MENTAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to walk; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. The employee frequently is required to stand; sit; and stoop, kneel, crouch, or crawl. The employee is occasionally required to climb or balance and taste or smell. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception, and ability to adjust focus. Tolerate moderate noise level. Maintains emotional control under stress. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally exposed to outside weather conditions. The noise level in the work environment is usually moderate