Provider Specialist

Provider Specialist

Under general supervision, the Provider Specialist serves as the primary provider liaison for assigned child care providers. In this role, the Provider Specialist delivers high-quality internal and external customer service and is responsible for maintaining provider files in compliance with California Department of Social Services (CDSS), Child Care and Development Division regulations, and CDA policies and procedures.

Essential Duties and Responsibilities

1. Serve as the primary point of contact and provider specialist for an assigned provider caseload; caseload size may vary based on operational needs.
2. Provide comprehensive training and technical assistance to enrolling and existing child care providers, including participation requirements, reimbursement processes, and CDA policies and procedures.
3. Conduct provider orientations and training presentations related to participation requirements and quality child care practices.
4. Collaborate with other CDA departments to research provider status and reimbursement inquiries; request verified adjustments and follow up as needed.
5. Maintain accurate and compliant provider files by requesting updated documentation, tracking required information, processing changes, and meeting established timelines.
6. Provide walk-in, phone, and written customer service support to enrolling and enrolled providers.
7. Evaluate and interpret provider reimbursement rates for accurate data entry and ongoing file maintenance.
8. Maintain organized digital provider files that document the history of provider participation, verifications, and approvals.
9. Conduct provider file reviews for quality control as assigned.
10. Conduct enrollment limitation and capacity reviews for assigned providers by generating reports; analyzing and documenting findings; collaborating with partnering agencies and collecting required data as needed to complete enrollment limitation reports; communicating limitations, corrective actions, and timelines to providers using approved tools; and completing disenrollment actions by preparing notices, tracking due dates, maintaining documentation, and updating internal systems in accordance with established procedures and timelines.
11. Reconcile error reports by identifying compliance-related errors; correcting provider files and database entries accurately and within assigned due dates; and reviewing corrected items to understand root causes and apply lessons learned to future work to prevent recurring errors.
12. Monitor assigned providers for licensing changes by reviewing the Community Care Licensing website when notified of changes; follow established procedures for license closures or changes; obtain clarification from providers as needed; and ensure required steps are completed to initiate timely notification to enrolled families.
13. Participate in program integrity reviews and special projects by completing assigned tasks accurately and timely; gathering and reviewing required documentation; following established procedures; identifying and reporting potential compliance issues; documenting actions and outcomes; and supporting corrective actions as directed.

Additional Duties and Responsibilities

1. Maintain confidentiality and follow privacy laws, rules and regulations, and procedures in regards to record keeping, using appropriate judgement in answering questions, releasing information considering the consequences of disclosure.
2. Represent program and Agency at professional organizations and community events or meetings as needed.
3. Participate in on- and off-site learning opportunities such as workshops, conferences, staff meetings and trainings.
4. Assist in the training and mentoring of other staff members as needed.

Minimum Education, Experience & Requirements

Associate's Degree in Early Childhood Education, Human Services or related field preferred. One-year related experience and/or training, or equivalent combination of education and experience to include; experience working with the child care community, subsidy program and/or non-profit sector with a focus on reimbursement.

Knowledge, Skills & Abilities

Must possess excellent interpersonal skills; ability to build strong and positive relationships/partnerships, establish rapport and credibility at all levels; maintain confidentiality and sensitive information private. Ability to handle crisis situations calmly and work with individuals of varying educational, social-economic backgrounds.

Strong administrative skills; must be able to prioritize, pay attention to detail, and calculate mathematical equations and formulas accurately; ability to maintain composure under pressure and meet strict deadlines; strong verbal and written communication skills.

Must be proficient in Microsoft Office, to include Word, Excel, Power Point and Outlook; experience with human services organizations and bilingual/Spanish preferred.

Work Environment

General office environment that may require interactions with customers with a range of moods and emotions. Customers may behave in a manner which is irrational, unreasonable, unsettled and/or hostile. All require patience and skill being tactful and understanding so not to alienate or antagonize.

Reasonable accommodations in the work environment may be made to enable individuals with disabilities to perform the essential functions.

Physical Requirements

The physical characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this classification. Reasonable accommodations may be made to enable an individual with a qualified disability to perform the essential functions of a job, on a case-by-case basis.

Continuous: upward and downward flexion of the neck; frequent: sitting, repetitive use of hands to operate computers, printers, and copiers; occasional: walking, standing, bending, and twisting of neck, bending and twisting of waist, squatting, grasping, reaching above and below shoulder level, and lifting and carrying of objects weighing up to 20 pounds.

Work Schedule

Full-time, Monday Friday, 40 hours per week, typically 8:30 am to 5:00pm. May require evening and weekend hours based on the needs of the program.

This position may be eligible for a hybrid work schedule of up to twenty-four (24) hours remote and sixteen (16) hours in-office per week following the successful completion of training. Remote work is not guaranteed and may be modified, suspended, or discontinued at any time based on business and operational needs. In-person attendance may be required for trainings, meetings, or other agency-related

Benefits

• Medical | Dental | Vision - 80% paid by the employer in the first year, and 100% thereafter
• Ongoing Training and Staff Development opportunities
• Flexible Spending Account
• Legal Service Plans Available
• Paid Holidays, Sick Pay, and Vacation Time
• Additional Vacation Days Earn up to 5 bonus days after 3 years, and up to 15 bonus days after 10 years.
• Long-Term Disability
• Group and Voluntary Life Insurance Plan
• Annual Employer Contribution Plan and Employee 401(k) Contribution
• Employee Assistance Program

Child Development Associates