Pregnancy Promise Program Project Specialist -

Job Description

Job DescriptionHelp develop and revise project materials and outreach for referring agencies, including health care systems, human service agencies and community-based organizations

• Monitor, review and analyze performance outcomes and data quality for each of the four MCEs, and review biweekly MCE updates to ensure required CMS measures are met

• Ensure accurate data reaches OMPP so enrollment is reflected in CoreMMIS; work with OMPP on a CoreMMIS enrollment “check box” and on answering eligibility questions for potential enrollees

• Develop and revise MCE Complex Case Manager training materials

• Monitor and analyze performance and quality outcomes data for each MCE's complex case management program; assist and give feedback to MCE project managers

• Help develop and deliver stakeholder presentations, traveling statewide to present to all provider types, at conferences and at other events

• Help write quarterly and annual CMS reports; with the Project Manager, track grant activities to meet report and budget timelines and assist with CMS documentation requests during the grant period

• Help develop a new statewide MCE Complex Case Manager Best Practices Forum, collect quality improvement data, and facilitate implementation of new standard procedures

• Research, draft and disseminate complex case management best practice guidelines; draft a program manual, updated at least annually, covering guidelines, data requirements, case management practices, etc.

• Ensure grant funds are allocated per federal, state and grant guidelines and financial reports are submitted on time per federal requirements

• Address implementation barriers through field visits with MCE and community provider case managers, with problem-solving and feedback loops

• Develop agendas and coordinate cross-sector participants for regional meetings and MOM grant listening tours in the State's five Medicaid regions

• Serve as liaison to enrollees, community mental health center staff, referral sources and project partners; answer emails, calls and texts from enrollees, MCE care coordinators and other providers within 2 business days, providing program guidance

• Help develop the public-facing website of resources for members, loved ones and providers; review it for updates and work with the communications team on changes

• Manage website referrals: confirm Medicaid coverage/eligibility and route to the correct MCE

• Obtain and maintain Indiana Navigator licensure (8 hours of training, provider quiz, IDOI exam)

• Complete Medicaid applications for potential enrollees without coverage, with continuous outreach through 90 days postpartum

• Make all program materials as equitable and inclusive as possible; collaborate with Indiana 211 for members who are not eligible for the program

• Resolve disputes between MCE and community case managers; support and assist managed care case managers on individual client issues and best practices

• Coordinate with the Project ECHO Coordinator on curriculum, presenters and scheduling for case managers and community health workers serving the target population

• Work with the data and analytics team on developing an data app

• Record thorough, accurate minutes at all meetings for colleagues, MCEs and stakeholders

• Analytical, with keen attention to detail while keeping the broader picture and message in view

• Ability to resolve issues with professionalism and sensitivity and work well with other agencies and divisions

• Ability to use standard word processing, spreadsheet and database programs; compile, synthesize and present complex recommendations; and

• Passion for public service

Job Requirements:

• Bachelor's degree in social work, public health, public administration or similar; 4–5 years of healthcare or compliance experience may substitute

• Experience managing federal or state grants, including budget oversight

• Knowledge of state and federal laws, regulations and policies related to addiction treatment

• Ability to identify, analyze, summarize and communicate information, orally and in writing, and formulate recommendations

• Skill in coordinating work with agency staff, advisory groups and committees to achieve desired outcomes

• Ability to work effectively with diverse stakeholders, including individuals with lived experience, family members, advocates and mental health/addiction providers

• Knowledge of planning, program development and evaluation methods

• Flexible, creative, assertive and able to work in a multitask, multidisciplinary environment

• Expertise working with culturally diverse, at-risk populations

• Extensive understanding of Medicaid, waiver services and managed care, and extensive knowledge of state laws, policies and procedures pertinent to Medicaid programs

• Knowledge of care coordination and case management (prior experience preferred)