Quality Assurance Analyst

Medicaid Quality Assurance AnalystLocation: Baltimore, MarylandJob Type: 12 MonthsSkills Needed: DATA, MICROSOFT WORD, MICROSOFT EXCEL, TRAINING, MICROSOFT POWERPOINT, SHeets, Docs, Slides, providing technical assistance to Medicaid providers, experience with AW, health-related services, knowledge of federal HCBS Waivers, CMS Final Rule, policies and provider service procedures, experience analyzing Medicaid payments, policy, writing technical reports, implementing a quality assurance system for Medicaid services, MS365, Google G Suite applications, and formsJob Description: This request is to procure services to support MSDE, DEI/SES, to implement the school-Based Medicaid Program and AW program. The person in this position will:Support compliance monitoring and identify strategies to ensure compliance with Code of Maryland Regulations (COMAR) and federal Medicaid requirements of the school-Based Medicaid Program and Autism Waiver program. Examine, analyze, track, and interpret payments to Medicaid providers, documentation to support paid claims, and provider qualifications. Examine monitoring data, identify, and report discrepancies that could lead to high-risk COMAR compliance violations, prepare reports, and process Corrective Action Plans (CAPs) as assigned.Assist the Division in review of grants and technical assistance related to Local Application for Federal Funds (LAFF); Intergovernmental Transfer (IGT); Maryland’s Blueprint; Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit; Maryland Children’s Health Program (MCHP); and the AW as requested. Coordinate the dissemination of information regarding the AW provider application process, assist AW prospective providers through the application process, and collaborate with MDH to approve AW providers. Conduct AW prospective provider Statewide workshops on a quarterly basis, provide technical assistance to AW prospective providers, process applications from prospective providers in collaboration with the MDH, coordinate and lead structured interviews, and recommend approval to the MDH.Review and analyze data in Medicaid and school-based reporting structures: MA Grants database, Maryland Online IEP (MOIEP), Special Services Information System (SSIS), local Medicaid or IEP databases, AW Online Databases, AW Registry/Waitlist tracking system, AW performance measures, and MOVE IT secure transfer system. Recommend revision to rules, regulations, and procedures to support the expansion of the AW, and EPSDT for school-based services; for example, changes to COMAR 10.09.52 and 10.09.56. Provide training and technical assistance as needed with policy interpretation and agency collaboration in support of partnerships with the MDH, Medicaid providers, and community stakeholders.Mandatory Requirements: The Offeror shall meet the following minimum requirements:A. Minimum 3 years’ experience in monitoring and providing technical assistance to Medicaid providers.B. Minimum 3 years’ work experience with the AWC. At least N/A references that relate to the experience listed in the Scope of Work.Offeror Qualifications: Essential Requirements1. Demonstrated knowledge of State and federal requirements for health-related services under the IDEA (Part B and C) through demonstrated experience working for a state or LEA.2. Demonstrated knowledge of federal HCBS Waivers, including the AW and the CMS Final Rule. Must have expertise in eligibility policies and provider service procedures pursuant to implementing Maryland’s HCBS Waiver for Children with ASD.3. Demonstrated understanding and a minimum of three years’ experience in monitoring and providing technical assistance to Medicaid providers regarding COMAR 10.09.36, COMAR 10.09.50, COMAR 10.09.52, COMAR 10.09.56, COMAR 10.09.25, and COMAR 10.09.40.4. At least three years’ experience analyzing Medicaid payments, policy, data, writing technical reports, training, and providing technical assistance to local providers responsible for implementing a quality assurance system for Medicaid services.5. At least three years’ experience implementing State or federal level interagency agreements pertaining to Medicaid.6. Excellent organizational skills, as well as good oral and written communication skills; and7. Strong skills and experience with Microsoft Excel, Microsoft Word, Microsoft PowerPoint, MS365, and Google G Suite applications, such as, docs, sheets, slides, and forms.Education Requirements: Must possess a master’s degree or higher in education or a human service field from an accredited college or university.