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Medicaid Waiver Specialist
Location: San Francisco, CA, US
Salary Range: $51,923.00 To $62,308.00 (USD) Annually
Join our mission-driven team at GGRC! We're a non-profit organization that empowers individuals with intellectual and developmental disabilities in San Francisco, Marin, and San Mateo counties. By connecting individuals to innovative services and support, we're creating inclusive communities where everyone can thrive. Your work will make a meaningful impact on the lives of those we serve, and you'll have the opportunity to be part of a team dedicated to making a difference.
What makes GGRC so special?
At GGRC, diversity is not just a buzzword, it's a fundamental part of who we are. We believe that by bringing together individuals from all backgrounds and experiences, we can better address complex challenges and create a more inclusive community. We value and respect each person as a unique individual and prioritize their needs and aspirations. Whether it's a colleague, a person we serve, or a stakeholder, we approach everyone with clear and attentive inquiry to understand what is important to them and how we can best support them. At GGRC, we are passionate about building a more equitable and compassionate world.
What the Medicaid Waiver Specialist will do:
We are looking for a Medicaid Waiver Specialist to determine client eligibility for the Medicaid Waiver program in compliance with Federal and State regulations. This position also provides trainings to and consultation to case managers on eligibility requirements.
When you are considering a new job, its normal to have tons of questions. Here are a few things we get asked all the time:
Where will I work?
This role offers the opportunity to work in our San Francisco office.
What youll Do:
Eligibility
- Upon meeting QIDP qualification standards, review individuals file and make recommendations concerning eligibility to Med Waiver Nurse
- Update eligibility list as requested.
- Prepare the necessary paperwork for review and eligibility determination.
- Collate and distribute eligibility documentation.
Institutional Deeming
- Prepare referrals.
- Process completed referrals including communication with GGRC staff and Medi-Cal specialists.
- Identify and develop list of clients with active Medi-Cal on a monthly basis.
- Prepare and process required paperwork for eligible clients.
Terminations
- Communicate with Case Managers regarding terminations of benefits.
- Prep DS 3770
- Prepare and distribute correspondence, including NOA/certified mail at direction of Med Waiver nurse.
Recordkeeping
- In collaboration with the assigned social worker, ensure case records are properly prepared to meet the standards set forth by the Medicaid program requirements and recommend related corrective actions to address deficiencies or inconsistencies.
- Ensure that all necessary documentation is included in the file.
- Recertifications [upon meeting QIDP Qualification standards]
- Perform Annual Recertification for clients who are Medicaid Waiver by reviewing case records to assure all qualifying deficits are supported by current documentation. Refer complex cases to Med Waiver Nurse
- Assure timely completion and filing of Consumer Choice of Services/Living Statement
- Identify all qualifying conditions and document on the DS 3770 and Medicaid Waiver Client Summary Profile
- Review State and GGRC Recertification lists to ensure the information on both lists is accurate and complete.
- Keep track of completed Recertifications.
- Ensure timely receipt of Reports and DS 3770s from IT and sort as required.
- Collate and distribute Recertifications as required.
Who You Are:
You have:
- Good communication skills and interpersonal skills.
- Knowledge and ability to practice Person Centered Thinking skills.
- Experience in multicultural settings and/or multilingual capacity desired.
- Experience in determining quality assurance is preferred.
- Knowledge of principles of developmental assessment and intervention, and the ability to recognize changes in the level of care.
- Ability to extract and analyze pertinent information from various sources, including internal and external medical records and case notes.
- Ability to interpret and apply federal, state, and county eligibility regulations and agency procedures.
- Excellent communication skills, both verbal and written, to effectively convey complex information and ideas in a clear, concise, and professional manner.
- Strong problem-solving skills to identify and resolve operational difficulties.
- Collaborative mindset, working well with others to achieve agency and department goals.
- Proficiency in accurately documenting required information in individuals' files.
- Ability to work under pressure and meet deadlines for time-sensitive projects.
- Basic familiarity with software applications such as MS Word, MS Excel, MS PowerPoint, MS Outlook, or similar.
- Typing speed of 60 words per minute for efficient data entry and documentation.
- Demonstrated discretion and the ability to maintain strict confidentiality.
Requirements
Medicaid Waiver Specialist Required Qualifications:
Education & Training:
- Bachelors Degree in Human Services field required (e.g., Sociology, Psychology, Special Ed.)
- Able to meet the standards for being QIDP qualified, according to State administered Federal law 403(a), strongly preferred.
- 1-3 years administrative experience in professional setting performing a variety of administrative functions
- 1 year experience working with personal with developmental disabilities strongly preferred
- Experience in multi-cultural settings and/or multi-lingual capacity preferred
How to Apply:
GGRC values diversity; people of all backgrounds are encouraged to apply. Please complete the application and submit your most recent resume. If you feel that the questions do not accurately capture what you have to offer Golden Gate Regional Center, you are also welcomed to attach a cover letter. Applications are being reviewed on a rolling basis, so we encourage you to submit yours soon. We look forward to reading your application.
Employees are required to have the Covid-19 vaccine unless they have a religious or medical exemption.
Golden Gate Regional Center is an Equal Opportunity Employer.
San Francisco Applicants: Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Benefits
What are the benefits to working with GGRC?
Generous Tuition Reimbursement Program that reimburses qualifying employees up to $10,000 per fiscal year.
We offer a comprehensive benefits package including:
- Medical and Dental with a generous employer contribution
- Additional employer paid Life, Disability and Vision coverage
- 10% employer contribution to a 403(b) retirement account to help you save for the future!
GENEROUS TIME OFF BENEFITS!!! No really, we mean generous:
- 13 vacation days
- 15 sick days
- 10 paid holidays
- 4 personal holidays
- 3 winter holidays
- Up to 5 paid days for continuing education
Golden Gate Regional Center
