Job Information
North Carolina State University UTS - Temporary HCBS Waiver Analyst (NC DHHS) in Raleigh, North Carolina
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Department: 480502 - UHR UTS/UNC Partnership
Location: Raleigh, NC
Essential Job Duties:
This temporary position will assist the Division of Health Benefits ( DHB ) Long Term Services and Supports ( LTSS ), Community Alternatives Program ( CAP ) team. Each position is assigned
to the Department of Health and Human Services – Division of Health Benefits. The position will ensure the administrative oversight of enrollment in two 1915© HCBS waivers.
Position Overview:
This position will provide administrative support to two 1915 © Home and Community-based Services waivers, known as the Community Alternatives Program for Children ( CAP /C) and
Disabled Adults ( CAP /DA). The CAP waivers are authorized under section1915© of the Social Security Act and comply with 42 CFR § 440.180. These programs provide a cost-effective alternative to institutionalization by supporting a physically disabled Medicaid beneficiary to remain in or return to a home and community-based setting. This position is critical for overseeing quality improvement strategies for two 1915© HCBS waivers administered by NC Medicaid. This position will provide quality assurance and performance improvement oversight in monitoring, plan of care development, enrollment, disenrollment requirements, and critical incident reporting. This position will conduct analyses of
utilization data (paid claims, ER visits, falls, and other critical medical events) to analyze program performance and root causes for critical incidents to identify trends and anomalies and recommend strategies for improving program compliance and the health and well-being of
program participants. This position will record and report analysis from reviews to internal and external stakeholders and committees.
Other Work/Responsibilities:
Ensuring the health and well-being of the more than 13,000 active waiver participants by tracking and evaluating critical incidents, reported and non-reported.
Evaluating root cause analysis of Level II critical incidents to ensure a comprehensive plan is in place to prevent occurrences of like incidents and mitigate future potential incidents.
Conducting quality assurance reviews on randomly selected service plans to confirm the plan of care is developed to meet the identified needs of the program participant that may mitigate critical incidents.
Reviewing the provider’s policy on restraints and seclusion to ensure alignment with the CAP waiver’s restraint and seclusion policy requirements.
Required Qualifications:
Proven ability to communicate effectively and professionally with employees, managers, and the public (in-person, online, in writing, and on the phone)
Proficient in Microsoft Office products, including Word, Excel, and Outlook
Ability to establish and maintain effective working relationships with other state agencies, providers of services, advocacy groups, and other organizations
Ability to work independently with minimum or no supervision
Ability to effectively manage multiple tasks and priorities
Proven experience in collecting and analyzing programmatic data
Working knowledge of long-term care supports and services and home and community-based care
Proven ability to interpret and apply complex Federal and State regulations
Demonstrated ability to implement corrective measures to promote continuous quality improvement
Preferred Qualifications:
Master’s degree in Public Administration, Public Policy, Public Health, Nursing, Social Work
Considerable knowledge of long-term services and supports and community-based services
Experience in making utilization decision for medical and non-medical services
Experience providing technical assistance and policy interpretation to providers and Medicaid beneficiaries
Demonstrated ability to work with a team
Considerable knowledge in working with health records
Required license or certification:
N/A
Position Number: 48CK24
AA/EEO Statement:
NC State University is an equal opportunity and affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, gender identity, age, sexual orientation, genetic information, status as an individual with a disability, or status as a protected veteran.
If you have general questions about the application process, you may contact Human Resources at (919) 515-2135 or workatncstate@ncsu.edu. Individuals with disabilities requiring disability-related accommodations in the application and interview process, please call 919-515-3148.
Final candidates are subject to criminal & sex offender background checks. Some vacancies also require credit or motor vehicle checks. If highest degree is from an institution outside of the U.S., final candidates are required to have their degree equivalency verified at www.wes.org or equivalent service. Degree(s) must be obtained prior to start date in order to meet qualifications and receive credit.
NC State University participates in E-Verify. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States.