NET Compliance Specialist

SCOPE OF POSITION:
Serves as a subject matter expert for assigned project/contract, primarily involving Medicaid Non-Emergency Transportation (NET), affiliated compliance and regulatory factors. Provides effective communication, education, and promotion of program services to Medicaid beneficiaries and others associated with NET, principally NET Brokers and/or NET Subcontractors. Collaborates with medical and other professional staff to meet contract deliverables within designated timeframes. Assures compliance with all aspects relative to the scope of the position and ensures facts are reflected in accurate reporting. Support the initiative to improve and ensure continuous improvements in the quality of research, investigative, and compliance methodology. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence Accountability, Respect and Teamwork.

ESSENTIAL JOB FUNCTIONS:

1. Maintain comprehensive knowledge of specialty area, pertinent organizations, health care environment, and organizations related to NET. Knowledge should include information regarding contract, contract deliverables, policies and procedures, resources available, current research, reports, and trends, as well as a thorough understanding of the NET Transportation Broker agreement with DMS/DHS.
2.  Maintain knowledge of regulatory guidelines as stated in the NET Broker agreement with the state and their application to contract deliverables.
3. Point of contact for NET Brokers and DHS/DMS regarding mandatory contract compliance documents as per NET Broker agreement with the state and department contract deliverables.
4. Primary validator of mandatory compliance documents as they are defined in the NET Broker agreement with the state.
5. Secondary and sometimes primary validator with regard to vehicle compliance documentation.
6. Responsible for maintenance and updates of the NET compliance portal and managing changes to compliance documents as they relate to status changes.
7. Monitor NET Compliance portal for ineligible NET driver/attendant’s compliance documents from Brokers and examine for errors or alterations to original documents.
8. Collaborate with NET Brokers to assist them in contract adherence and uploading compliance documents to the NET Compliance Portal.
9. Responsible for secondary support of Arkansas Medicaid Non-Emergency Transportation (NET) Helpline and/or Extension of Transportation Services (EOTS) lines utilizing research and investigative approaches in order to achieve complex complaint resolutions and meet contract deliverables as assigned. 
10. Secondary and sometimes primary responsibility for the resolution of customer/beneficiary complaints/issues and requests including research, investigation, policy review, complex solution development, documentation and follow up in accordance with established policy and procedures.
11. Maintain knowledge of various information systems such as state information systems and those associated with preauthorization of non-emergency transportation services.
12. Communicate effectively with customers and/or beneficiaries. Develop and maintain collaborative relationships as necessary to meet contract deliverables of specialty area project.
13. Understand and utilize project-tracking database to document and monitor activities provided and to compile a comprehensive database of activity. Maintain accurate statistical data to meet contractual and other reporting requirements.
14. Understand and maintain knowledge regarding the use of any State data applications and policies used in accordance. 
15. Coordinate the timely collection and data entry of all required documentation ensuring all internal Quality Assurance and HIPAA guidelines are followed.
16. Monitor specific items within the area of focus, provide recommendations/ feedback to external customers for quality improvement and follow through for compliance of recommendations for improvement. 
17. Maintain knowledge in all other areas of Outreach Services teams to assist as needed with the overall operation of the Outreach Services department.  
18. Communicate needs and requests to other team members as appropriate.
19. Ensure compliance with AFMC policy, contractual obligations, state and federal laws, regulations and compliance documentation.
20. Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance in conjunction with AFMC’s internal quality measures.
21. Daily quotas may be added to meet contract deliverables as needed.
22. Additional duties as assigned.

KNOWLEDGE, SKILLS AND ABILITIES:

• Intermediate skill level with MS Office (Excel, Word, PowerPoint, and Outlook).
• Type 50 wpm.
• Strong skills in business English and spelling.
• Ability to maintain confidentiality.
• Strong oral and written communication skills.
• Creativity and flexibility.
• Ability to meet deadlines.
• Attention to detail.
• Medical terminology.
• Ability to work collaboratively and independently to achieve stated goals.
• Initiative.
• Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients and the public.
• Ability to multitask.
• Ability to prioritize.
• Strong organizational and problem-solving skills.
• Professionalism.
• Ability to read, interpret and apply laws, rules and regulations.
• Time management skills.
• Regular and punctual attendance.
• Ability to work overtime as needed.
   

Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to lift and transport 30 pounds. Must be capable of performing the essential functions of this job, with or without reasonable accommodations.

EDUCATION:
Required: High School Diploma
Desirable: Associate’s degree or additional education

EXPERIENCE:
Required: Two (2) years of experience in health care community, research, compliance and regulatory adherence, and complex problem/complaint resolution.
Desirable: Previous experience in Medicaid and/or non-emergency medical transportation.

INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)
An upload speed of at least 2Mbps is required to support softphone functionality.