Contract Coordinator

Madison, Wisconsin
Administrative & Support Services (Office and Administrative Support Occupations)
Job Type
Working Hours
8:00 AM - 5:00 PM
US$ 25.00 - US$ 30.00 per hour
Ref. Number
Shedosky, Alicen, Spherion
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Job Description

Under the general direction of the assigned supervisory Program Manager, the primary objective of this position is to provide state oversight of programs that demonstrate consumer-responsive ways of reforming the health and long-term care systems. Social services experience is a must and long term care experience is strongly preferred!

As part of the Family Care Program Administration Team, this position provides program and administrative support to managed care organization(s) (MCOs), the counties they operate in, managed care contract agencies, Tribal agencies and other providers of Department programs and services in assuring individuals have access to all needed supports and services, and to assure coordination, communication and collaboration among entities so that the use of federal and state resources are used in the most cost-efficient and effective manner. Incumbents in this position will serve as the primary point of contact between assigned (MCOs) and DHFS, with primary responsibility for assuring the MCO is meeting contracted Department program requirements and continually improving its performance in meeting the outcomes of its members. The position provides administrative consultation in quality improvement activities, compliance with performance and outcome standards to assure that services are integrated, available, accessible and efficiently delivered to the State's frail elderly and adults with developmental disabilities and physical disabilities. Incumbents must be knowledgeable about all facets of the MCO's operations, including business systems developed to support the MCO's core activity of care management and service provision. Incumbents must be expert in all areas of Family Care and Medicaid managed care requirements, understand the philosophy of person-centered care and personal outcomes, and work closely with assigned Member Care Quality Specialists. The incumbent will work closely with assigned Member Care Quality Specialist and other content experts, but retains overall responsibility for assuring the assigned MCO(s) is meeting program requirements and striving to continually improve quality for all enrollees.

- As a member of the MCO Program Administration Team, implement and oversee state-supervised/locally administered managed care organizations providing long term care to our state?s most vulnerable citizens.
- Manage the initial MCO certification and annual recertification processes and facilitate the re-contracting process
- Facilitate and participate in communications between/among the MCO and the ADRC and local economic support offices in its service area to assure consumer access to benefits
- Facilitate and participate in communications between the MCO and counties in which it operates, and with Tribal agencies and other providers of Department programs and services as needed, in assuring individuals have access to all needed supports and services
- Oversee, monitor and bring to resolution DHFS-required remediation activities of the MCO
- Communicate effectively with Department staff and management, other state agencies, county, tribal and municipal governments, MCO, advocates, and the general public
- Other duties as assigned

Working hours: 8:00 AM - 5:00 PM

- Extensive knowledge of long-term care service delivery systems
- Extensive knowledge of the state and federal statutes, regulations, policies and procedures governing the Medical Assistance program and Medicare program
- Considerable knowledge of the principles and process of policy development and analysis
- Considerable skill in translating the problems and needs of frail and handicappedolder persons and of the delivery system that serves them into useful program improvements
- Working knowledge of research methods, fiscal analysis and budget preparation procedures
- Extensive skills in written, v

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