Medical Review Team Manager

Date Posted: Apr 24, 2024

Requisition ID: 442664

Location:

Indianapolis, IN, US, 46204

Begin a fulfilling career with the State of Indiana by joining one of the largest employers in the state, offering a diverse range of opportunities across 60+ agencies. At the state, you'll find competitive compensation, a robust benefits package and a commitment to work-life balance. Most importantly, you'll have the chance to make a real and measurable impact on the lives of Hoosiers across Indiana.

At the State of Indiana, we don’t just talk about diversity and inclusion—we make it our goal to create a welcoming, accessible, and equitable workplace with a workforce that is representative of Indiana's population. As a proud equal opportunity employer, reasonable accommodations may be available to enable individuals with disabilities to complete the application and interview process as well as perform the essential functions of a role.

About the Family & Social Services Administration:

The Division of Family Resources (DFR) within the Family and Social Services Administration (FSSA) is responsible for establishing eligibility for Medicaid, Supplemental Nutrition Assistance Program and Temporary Assistance for Needy Families benefits. The division also manages the timely and accurate delivery of SNAP and TANF benefits. DFR also provides employment and training services to some SNAP and TANF recipients. The division’s overarching focus is the support and preservation of families by emphasizing self-sufficiency and personal responsibility.

Role Overview:

This role manages the Medical Review Team, collaborating to make determinations regarding the medical eligibility of applicants for various programs administered by FSSA including the Indiana Health Coverage Programs. Your role oversees the Team's activities to maintain compliance with productivity and accuracy metrics, ensuring that proper eligibility determinations are made in a timely manner. You will also manage the processing of Burial Assistance Claims, collaborating with FSSA Accounts Payable, funeral homes, and cemeteries. Your role will supervisor other state employees and various contactors that include physicians, phycologists, and registered nurses.

The ideal candidate will have a Bachelors Degree plus a minimum of five years of medical or management experience, or equivalent work and management experience can substitute for the education.

Salary Statement:

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

A Day in the Life:

The essential functions of this role are as follows:

• Plan, organize, direct, monitor, and participate in ongoing comprehensive development and implementation of specialized programs and development within the agency.

• Determine, analyze, identify and implement long-range objectives and specifying the strategies, KPIs, and actions to achieve them.

• Analyze operations to evaluate performance of the specific program or its staff in meeting objectives or to determine areas of potential cost reduction, program improvement, or policy change.

• Interpret and explain in-depth and complex policies, rules, regulations, or laws to organizations, government or corporate officials, or individuals.

• Develop and implement corrective action plans to solve organizational or departmental problems.

• Prepare and present reports for approval, including those for funding or implementation of services to executive leadership.

• Develop and oversee program financial or budget activities to fund operations, maximize investments, or increase efficiency.

• Develop and monitor program requirements to ensure it meets federal and state policies and grants compliance.

• Develop and supervise training of employees and consultants on program requirements and usage.

• Develop, coordinator, and deliver communication plans and communications.

• Preside over, or serve on, boards of directors, management committees, or other governing boards.

• Recruit, select, onboard, and train employees to ensure role responsibilities and expectations are clearly understood while providing opportunities to continue professional development.

• Set expectations, measure progress, provide ongoing feedback, and evaluate the performance of employees. Ensure work adheres to quality standards, deadlines, and proper procedures.

The job profile is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Other duties, responsibilities, and activities may change or be assigned at any time with or without notice.

What You'll Need for Success:

The ideal candidate in this role should minimally have either

• a Master’s Degree and 7+ years of experience, or a Bachelor’s Degree and 9+ years of experience, or

• an Associate’s Degree and 11+ years of experience, or

• at least 13+ years of experience applying the below, outlined knowledge, skills, and abilities in a similar role.

You must meet the following requirements to be considered for employment:

• Extensive knowledge of the principles, practices, and techniques of a broad area of training and education, including texts and materials developed in the field.

• Thorough knowledge of the agency or institution’s functions, operations, and purpose.

• Considerable knowledge of experiential learning techniques.

• Practical knowledge of laws, rules, and regulations governing mandated training within the agency.

• Ability to develop, monitor and evaluate broad training programs.

• Ability to plan and conduct seminars, workshops, and training sessions.

• Ability to assemble training materials, including writing comprehensive manuals and assembling texts, films, slides, and characters.

• Ability to establish effective and cooperative working relationships with trainees, other instructors, and the entire agency staff.

• Effective communication skills.

• Ability to keep current on new trends, philosophies, and available materials regarding adult education.

• Ability to delegate work, set clear direction, and manage workflow.

• Ability to effectively give feedback, provide guidance or corrective action, coach, and develop employee skill sets.

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

• Flexible work scheduling options, including the potential for hybrid remote work for employees whose work may be performed outside state facilities

• Deferred compensation 457B account (similar to 401k 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

• 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

  Equal Employment Opportunity:

  The State of Indiana is an Equal Opportunity Employer and is committed to recruiting, selecting, developing, and promoting employees based on individual ability and job performance. Our policy is to provide equal employment opportunity to all people in all aspects of employer-employee relations without discrimination because of race, color, creed, religion, sex, national origin, ancestry, age, sexual orientation, gender identity, physical or mental disability, or veteran status. We will comply with the spirit as well as the letter of all applicable state and federal laws.

  If you are a qualified individual with a disability and require reasonable accommodations to complete this application, you can request assistance by contacting the Indiana State Personnel Department at [email protected] .

  The State of Indiana has established a culture that welcomes equity, inclusion, and opportunity for all employees and applicants. We encourage you to apply if you feel you have the transferrable skills to be successful in this position and we look forward to reviewing your application.

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