This in-office position provides operational support to ensure efficient program functioning, with a primary focus on Person-Centered Plan (PCP) development support, service authorizations, audit readiness, and community outreach.
Key Responsibilities
PCP Development & Program Support
- Support clinical staff with development, tracking, and maintenance of Person-Centered Plans (PCPs).
- Actively participate in monthly program and weekly team meetings.
- Ensure PCP documentation is completed, updated, and compliant with Sunrise requirements.
- Monitor due dates for treatment plans, reviews, and required signatures.
- Assist with collection and organization of supporting documentation for service plans.
- Coordinate with program staff to improve workflow and documentation standards.
- Assist leadership with special projects and process improvement initiatives
Authorizations & Utilization
- Submit initial and concurrent service authorization requests to payors (e.g., Medicaid, MCOs) in a timely manner.
- Track authorization statuses, units, and expiration dates to ensure uninterrupted services.
- Maintain accurate authorization logs and notify leadership of pending expirations, denials, or service gaps.
- Assist with authorization appeals, reconsiderations, and follow-up communications as needed.
Audit & Compliance
- Assist with internal audits of client records, service documentation, and program compliance.
- Prepare records and supporting materials for external audits, payor reviews, or accreditation visits.
- Monitor documentation quality and report deficiencies to leadership.
- Support corrective action plans and quality improvement initiatives.
- Maintain organized administrative systems for compliance tracking.
Qualifications
Education & Experience
- Bachelor’s degree in Healthcare Administration, Human Services, Social Work, Business, or related field preferred.
- Minimum of 2 years of experience in healthcare administration, behavioral health, or human services with a focus on PCP development and support.
- Experience with Medicaid services and community-based programs strongly preferred.
Knowledge, Skills & Abilities
- Extensive experience with Person-Centered Planning and clinical documentation requirements.
- Knowledge of service authorization processes and Medicaid compliance standards.
- Strong organizational, administrative, and communication skills.
- Ability to manage multiple priorities and deadlines.
- Experience with audits, compliance monitoring, or quality assurance preferred.
- Proficiency in Microsoft Office, EHR systems, MCO portals.
**We will be moving to N. Duke Street in a few months.
Pay: From $45,000.00 per year
Benefits:
Education:
Experience:
- Enhanced Services (CST, IIH): 2 years (Required)
- Person-Centered Plan development: 2 years (Required)
Ability to Commute:
- Durham, NC 27707 (Required)
Work Location: In person
