Provider Compliance Lead

Role Overview

• Provide statewide coordination, direction and specific technical assistance to Regional APD offices regarding programs within the APD services system.
• Provide technical and functional recommendations, leadership and guidance regarding the workflows in provider terminations, Provider adverse actions, Changes of Ownership (CHOW), and background screenings.
• Foster a positive and collaborative team environment, promoting professional growth and development among team members.
• Conduct regular team meetings to facilitate communication and knowledge sharing.
• Monitor provider actions inbox daily to ensure incoming work is tracked and organized.
• Deliver technical assistance and information to unit staff and regional staff.
• Notify regional offices of termination review decisions in a timely and professional manner.
• Organize cases and facilitate staff reviews with the Office of General Counsel and Operations.
• Ensure that terminated providers are closed in all relevant APD and AHCA systems.
• Create and present summary data reports on provider terminations to management.
• Act as liaison with Agency for Health Care Administration and the Medicaid fiscal agent.
• Coordinate with the Medicaid fiscal agent, providers, and regional offices regarding provider actions.
• Provide technical assistance and training to Regional staff regarding all aspects of provider actions and terminations.
• Update relevant data systems with provider information.
• Collaborate with communications to create revisions to provider web content.
• Provide technical assistance to current providers on provider record maintenance.
• Compile reports, review trends, and develop processes in response to data to improve processes.
• Coordinate Provider Background Screening application processing.
• Assist the Regions in the coordination of all CHOW process steps.
• Manage unit initiatives to ensure successful and timely completion.

Requirements

• Proficiency with Microsoft Word and Excel.
• High School diploma or its equivalent.
• Knowledge of DD/HCBS Medicaid Waiver and Florida's Developmental Disabilities system.
• Rules, policies, procedures and laws related to the DD/HCBS iBudget Waiver program.
• Ability to develop rules, policies and procedures related to Florida's Waiver and Medicaid program.
• Ability to understand, apply and interpret applicable statutes, rules, regulations and policies related to the waiver program.
• Ability to communicate effectively both in writing and verbally.
• Ability to establish and maintain effective working relationships with coworkers, Field Office staff, consumers, family members and other stakeholders.
• Ability to work independently.
• Ability to learn and communicate complex information.
• Ability to plan, organize and coordinate work assignments.
• Skills in producing information, data analysis, and reports to executive leadership.

Benefits

• Annual and Sick Leave benefits.
• Nine paid holidays and one Personal Holiday each year.
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options.
• Retirement plan options, including employer contributions.
• Flexible Spending Accounts.
• Tuition waivers.
• Paid Maternity and Parental Leave.