Medicaid specialist

Responsibilities

North Spring Behavioral Healthcare, Inc. is a multifaceted behavioral healthcare system comprised of three programs to serve children and adolescents with a broad spectrum of psychiatric service needs.

Programs of service include an 87-bed, Virginia Department of Behavioral Health and Developmental Services licensed, Joint Commission accredited psychiatric residential treatment facility, a Partial Hospitalization Program, and a 40-bed acute psychiatric hospital.

Our strategic plan for the past two years has been centered on improving fidelity to our evidence-based clinical methodology.

North Spring is part of Universal Health Services, Inc. (UHS) one of the Nation’s largest and most respected healthcare management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide.

Founded in 1978, UHS subsidiaries now have more than 83,000 employees. The UHS business strategy is to build or purchase healthcare properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control.

Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion.

Our Risk Management and Quality Assurance Department is looking for a fulltime Medicaid Specialist.

Location : Beautiful Leesburg, Virginia, 40 miles Northwest of Washington DC. Named one of the best places to live by Money magazine.

45-acre campus in a rural area on the northern edge of Leesburg with a gymnasium, beautiful outdoor campus and high ropes course.

Excellent public school system.

North Spring Behavioral Healthcare offers comprehensive benefits for the Medicaid Specialist position, such as :

• Challenging and rewarding work environment
• Competitive Compensation
• Excellent Medical, Dental, Vision, and Prescription Drug Plan
• Generous Paid Time Off
• 401(K) with company match and discounted stock plan
• Career development opportunities within UHS and its Subsidiaries

Position Summary :

This position is responsible for ensuring institutional compliance with the Virginia Department of Behavioral health and Developmental Services, Virginia Medicaid Services, Tricare and Joint Commission.

This position is tasked with ongoing compliance audits of current medical records.

Key Responsibilities :

• The Medicaid Specialist is tasked with auditing all open charts concurrently to ensure that the medical records documentation meet the requirements of the regulatory agencies mentioned above.
• The Medicaid Specialist must report regularly to the Director of Risk Management and Quality Assurance regarding the results of their audits, and prepare to disseminate this information to the appropriate Department Head.
• The Medicaid Specialist will prepare in-services and educational programs necessary to ensure that all levels of direct-care staff are aware of the regulations and expectations of the above named organizations.
• The Medicaid Specialist must create and implement a system to determine if the education or in-services provided are having an impact upon staff documentation.
• The Medicaid Specialist must participate directly in any audit of the organization by the above named agencies and assist with reviewing the findings to ensure validity, and developing action plans.
• The Medicaid Specialist must be a standing member of the Utilization Review Committee.
• Other duties as assigned based on the needs of the facility.

Qualifications

Qualifications :

Skills, Knowledge and Abilities : A combination of mental health experience, auditing and knowledge of Virginia Department of Behavioral health and Developmental Services, Virginia Medicaid Services, Tricare and Joint Commission standards.

The required knowledge, skills, and abilities must be documented and observable in the application form and interview and can be verified by additional references.

• Must know how to gather and analyze data.
• Must be detail oriented and possess superior documentation skills.
• Must be articulate, assertive, and able to communicate effectively (verbally and in writing) with employees and the management team.
• Must possess a basic understanding of and comfort level with medical terminology, residential treatment, clinical science / pathology and psychiatric disorders.
• Must also demonstrate initiative, tact and good judgment.
• Must have basic computer skills.

A highly competitive applicant would have the following skills / traits :

• Proficient in Microsoft Excel (Pivot Tables / Formulas)
• Document Auditing Experience
• Eagerness to understand regulations and forces that impact the system
• Always seeking options for process improvement
• Willing to own processes

Education & Experience : A minimum of a Bachelor’s Degree in human services field (i.e. psychology, social work, counseling) is preferred.

At least two year of recent experience in mental health work with this population.

Physical Demands : Must be able to :

Must be able to :

• Lift and carry up to 50 pounds.
• Stand, walk, kneel, and reach while working with residents at times throughout the day.
• Use the full range of body motion including handling and physically restraining residents when necessary.
• Perform First Aid and CPR.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates.

UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.

from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc.

If you feel suspicious of a job posting or job-related email, let us know by contacting us at : or 1-.

Last updated : 2024-05-02