LTC Reimbursement Manager

About The Family & Social Services Administration

The Office of Medicaid Policy and Planning (OMPP) is a division within the Family and Social Services Administration, which receives around 18 percent of the state's budget to ensure vital health care coverage to approximately 1 in 4 Hoosiers. OMPP strives to build programs and processes that enable Hoosiers to live in fully engaged communities and reach their greatest emotional, mental, and physical well-being. Our mission is to support individual and community well-being with effective and efficient programs, remarkable collaborations, measurable impact on individuals and communities, and an energized staff that is fully engaged with this mission.

Role Overview

This role oversees reimbursements for the long-term care services as provided through a variety of Medicaid programs including a managed care program for Long-Term Supports and Services (PathWays for Aging), the State Fee for Service program, the Program for All-Inclusive Care for the Elderly (PACE) program and a variety of waiver programs.

Salary

The salary for this position traditionally starts at $75,010.00 but may be commensurate with education and work experience.

A Day In The Life

The essential functions of this role are as follows:

• Position will provide leadership, day-to-day supervision and development opportunities to the Long-Term Care (LTC) Reimbursment team in the oversight and administration of reimbursment programs for skilled nursing facilites, group homes, PACE, home health care and hospice care.
• Provider reimbursement responsibilites include Medicaid benefit payments as well as Supplemental payment programs that provide enhanced benefit levels.
• Collaborate with OMPP Reimbursement / Financial / Rating Vendors to quanfity the fiscal impact of any LTC reimbursement changes.
• Serve as a subject matter expert for projects involving potential LTC reimbursment changes or for addressing reimbursement concerns being raised by providers or other stakeholders.
• Evaluates and audits Indiana Medicaid LTC reimbursement policies, practices and outcomes, including managed care entities and the State's Fiscal Agent which is responsible for reimbursement for fee-for-service programs.
• Represents the Agency and Division to external organizations, including but not limited to, providers, provider associations, advisory committees, MCEs, legislators, lobbyists and members in a manner that maintains the integrity of and enhances the reputation of Indiana Health Coverage Programs.
• Provides expertise to assist with policy development and implementation, ensuring proper review and incorporation of State and Federal law.
• Works and coordinates with other OMPP sections to ensure integrity and fidelity to agency mission and vision.
• Assist and own other projects in support of the agency's mission as assigned by supervisor, division executives, and agency leadership.

This position is exempt from overtime compensation for additional work hours which may be required to complete essential functions or other assigned work. Exempt employees may work more than 75 hours in a pay period without additional compensation and must report a minimum of 75 hours per pay period of work hours and/or paid leave taken to receive their base biweekly salary.

What You'll Need For Success

• Bachelor's degree in a related field (Accounting, Finance, Health Administration, or similar) with at least 5 years of healthcare experience.
• A minimum of three (3) years of management experience in LTC long-term care financial or operational roles.
• A minimum of two (2) years of staff management and evaluation experience.
• Strong leadership and creative problem-solving skills; must possess excellent verbal and written communication skills and the ability to effectively engage stakeholders including agency leadership, providers and provider associations, regulators, health plan executives and technical support teams.
• Knowledge of federal and state public health care programs and policy, healthcare purchasing, the health insurance industry, and national public health care issues and trends. Must be familiar with Medicaid delivery systems and underlying programs. Familiarity with Indiana Health Coverage Programs (IHCP) and Medciare programs is preferred.
• Ability to plan, initiate, and properly execute programs and initiatives. Must be highly self-motivated, analytically-minded, and possess the ability to manage multiple projects simultaneously.
• Ability to analyze and predict fiscal and operational impacts of any proposed reimbursement adjustments/corrections.
• Ability to anticipate and mitigate potential roadblocks or challenges to program development and success.
• Ability to resolve issues with professionalism and sensitivity; must work well with other agencies, divisions and support agency objectives.
• Proficiency in Microsoft Office Suite (Excel, Word, and PowerPoint).
• Ability to compile, synthesize, and present complex recommendations; and
• Passion for public service.

Supervisory Responsibilities/Direct Reports

This role may provide direct supervision for one or more staff members.

Benefits Of Employment With The State Of Indiana

The State of Indiana offers a comprehensive benefit package for full-time employees which includes:

• Three (3) medical plan options (including RX coverage) as well as vision and dental plans
• Wellness Rewards Program: Complete wellness activities to earn gift card rewards
• Health savings account, which includes bi-weekly state contribution
• Deferred compensation 457(b) account (similar to 401(k) plan) with employer match
• Two (2) fully-funded pension plan options
• A robust, comprehensive program of leave policies covering a variety of employee needs, including but not limited to: 150 hours of paid New Parent Leave and up to eight weeks of paid Childbirth Recovery Leave for eligible mothers
• Up to 15 hours of paid community service leave
• Combined 180 hours of paid vacation, personal, and sick leave time off
• 12 paid holidays, 14 on election years
• Education Reimbursement Program
• Group life insurance
• Referral Bonus program
• Employee assistance program that allows for covered behavioral health visits
• Qualified employer for the Public Service Loan Forgiveness Program
• Free Parking for most positions
• Free LinkedIn Learning access