Job Overview We are seeking a dynamic and strategic Operations Manager to lead Medicaid Waiver Programs, ensuring the delivery of high quality, compliant, and patient centered healthcare services. In this pivotal role, you will oversee the operational functions of Medicaid waiver initiatives, coordinate cross-functional teams, and drive performance improvements aligned with healthcare regulations and organizational goals. Your leadership will foster a culture of excellence, innovation, and compliance while managing complex healthcare operations within a regulated environment. This position offers an exciting opportunity to shape impactful programs that enhance community health outcomes and support vulnerable populations.

Duties Operations Leadership:

Directing daily agency functions, developing strategic plans, and driving data-driven performance improvement initiatives to optimize operational efficiency.

Medicaid Waiver Compliance:

Ensuring strict adherence to state Medicaid policies and standards, while leading internal file audits and HFRD state audit preparations.

Billing Management:

Overseeing medical billing workflows, managing resource allocation, and tracking service/prior authorizations via AxisCare, Tellus, and GAMMIS.

Cross-Functional Medical Coordination:

Fostering collaboration among clinical teams, nursing leadership, external case management entities, and administrative staff to ensure seamless care delivery.

Onboarding:

Managing client referrals and eligibility alongside caregiver HR workflows, including background checks, training records, and E-Verify compliance.

Experience Georgia Medicaid Waiver Expertise:

Proven background in healthcare management with a deep, specialized understanding of Georgia's EDWP, GAP, ICWP, NOW and COMP regulations and compliance requirements.

Executive Operations Leadership:

Extensive experience in operational management, developing strategic organizational plans, and directing multidisciplinary teams with a focus on medical and nursing leadership.

Compliance, Auditing, & Quality:

Strong track record in healthcare compliance, EVV tracking, caregiver file auditing, and leading rigorous HFRD state audit preparations.

Healthcare Software Proficiency:

Technical expertise in critical platforms including AxisCare, Tellus, GAMMIS, ADP, EVerify , and Google Workspace to drive data-based decisions.

Strategic Problem Solving:

Exceptional managerial communication skills to effectively resolve prior authorization bottlenecks, handle client escalations, and manage cross agency collaboration. Join us in transforming community health through innovative leadership! This role is perfect for a motivated healthcare professional eager to make a meaningful impact in the community while advancing their career in a fast paced, mission driven environment.

Pay:

$61,079.95 - $68,784.46 per year

Benefits:

Paid time off

Experience:

Medicaid Programs:

2 years (Required) Ability to

Commute:

Union City, GA 30291 (Required)

Work Location:

Hybrid remote in Union City, GA 30291