Summary: Responsible for assisting the Contract Administrator and Compliance Director with research and adoption of specific regulations that pertain to Non-Emergency Transportation for Medicaid Plan that are serviced by Coordinated Transportation Solutions. Also responsible for the general day to day oversight of Administrative functions to include facilities management, Financial Analysis as it relates to Call performance, Process oversight as it relates to claim and ancillary products.
Essential Duties and Responsibilities: Includes the following which may vary based on the scope of work for the specific Business Client. Other duties may be assigned.
· Research and document gaps between state regulations, Policy & Procedures and compliance and contractual commitments related to Centers for Medicare and Medicaid Services and related contractual requirements
· Perform compliance risk assessments.
· Generate Corrective Plans to address compliance gaps
· Interoperate contract language and report to Contract Administrator requirements that deviate from standard performance offerings
· Work with Account Management Team and QA Team to resolve compliance gaps.
· Perform contractual assessment for all facility services
· Prepare a quick reference guide of contractual requirements for all Funding Sources.
· High level of Financial and Business Acumen and understanding of business processes.
Non-Essential Duties and Responsibilities: include the following. Other duties may be assigned.
No non-essential duties and responsibilities have been assigned.
Responsible for own work and not normally required to direct or supervise other personnel but may occasionally instructor show another employee how to perform the work.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, including a minimum of 3-5 years’ experience in roles performing the Essential Duties and Responsibilities outlined above. The requirements listed above and below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Paralegal certification required
High School diploma required- Associates or bachelor’s degree or equivalent experience highly desirable.
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Ability to calculate figures and amounts such as discounts, interest, commissions, and percentages.
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Communicate with Supervisor on a regular basis about the successful components of work being performed and (when applicable) areas that have the potential to improve the productivity and quality. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
The ability to understand more advance computer skills and be proficient in the intermediate knowledge of software such as Microsoft Word and Excel.
Scope of Responsibilities
Incumbent generally establishes own work plan and priorities, using and/or modifying established procedures, to assure timely completion of assigned work in conformance with established departmental policies and standards; problems lacking clear precedent are usually reviewed with supervisor prior to acting.
Functions performed required the ability to communicate involved information with other employees or general public under conditions where basic understanding or sensitivity may be required to effectively promote and maintain relationships.
Certificates, Licenses, Registrations
Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand; walk and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision, color vision, depth perception and ability to adjust focus.
Note: Regularly – more than 2/3 of the time, Frequently – 1/3 to 2/3 of the time, Occasionally – less than 1/3 of the time
Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Training- will be two weeks- Dates to be advised.
CTS offers a competitive, performance based, salary and fringe benefits program. CTS is an equal opportunity employer regardless of race, color, religion, creed, sex, marital status, national origin, disability, age, veteran status, on-the-job injury, sexual orientation, political affiliation or belief. Employment decisions are made without consideration of these or any other factors that employers are prohibited by law from considering. Any discriminatory action can be a cause for disciplinary action.
Job Type: Full-time