Director of Medicaid(Job Number:
Description Chicago Public Schools is seeking a Director of Medicaid to develop and manage the District’s Medicaid enrollment, billing, and reimbursement work streams.
As the third largest school district in the country, with nearly 400,000 students - 80% of which are low income and 13.6% of which have IEP’s – the Director of Medicaid will be responsible for creating and overseeing the centralized processes by which enrollment, re-enrollment and provided services are captured, the reporting process for senior leadership, and managing the District’s Medicaid vendors.
Responsibilities The principal responsibilities include, but are not limited to:
- Implement efficient and effective processes across departments for:
o capturing all Medicaid-related data, o submitting monthly Medicaid claims, o resolving denied or failed claims, which should be reimbursable, o and monitoring compliance with current regulations.
- Establish Key Performance Indicators for each Medicaid work stream, and liaise with the corresponding teams to meet those goals.
- Manage the District’s Medicaid vendors, including generated reports, timelines, and processes.
- Work with the Director of Organizational Learning and department leaders to create and provide relevant trainings to providers, school staff, and families.
- Collaborate with CPS’ Medicaid vendor in the development of innovative revenue enhancement strategies as well as maximizing existing revenue streams including state and federal revenue. o Develop infrastructure to implement new revenue enhancements in partnership with
CPS’ Medicaid vendor and internal staff.
- Collaborate inter-departmentally to ensure alignment of revenue sustainability and revenue enhancement initiatives.
o Serve as lead liaison between the Office of School Finance, Office of Diverse Learner
Supports and Services, Office of Student Health and Wellness and CPS' Department of Transportation.
- Oversee existing state and federal revenue streams to provide sustainable funding for the district including but not limited to the Medicaid Administrative Outreach Claim and the district's Medicaid Fee for Service plan.
- Serve as the District’s subject matter expert on Medicaid; understanding current policy, as well as keeping current with revisions to state and federal Medicaid law, and interpreting / managing the implications of those changes for CPS.
- Coordinates with the Office of Student Health and Wellness to expand enrollment opportunities.
Qualifications The ideal candidate will have prior experience with some or all of the following: labor or data analysis, financial compliance reporting, school-based health services, and state and federal Medicaid guidelines.
Exceptional analytical and critical thinking skills.
Excellent time management, organizational skills professional and must be self-directed and self-motivated.
Thorough knowledge of Microsoft Office and Google Drive.
Strong writing and communication skills day-to-day basis as well as ensure enrollment into eligible Medicaid programs are maximized.
Working knowledge of Medicaid or other Federal reimbursement funding.
Working knowledge of school-based health services, including some familiarity with federal and state special education requirements.
knowledge of Illinois Medicaid program requirements, All-Kids, or other Illinois public benefits programs is strongly preferred; ability to quickly learn such requirements is required.
Proven effectiveness leading and holding accountable stakeholders from various departments or reporting units.
Experience establishing and using metrics or key performance indicators (KPIs) to manage performance and identify process improvements.
Ability to oversee a multifaceted process that involves data transfers, compliance reporting, policy interpretation and implementation, revenue monitoring, and frequent troubleshooting with stakeholders across the organization.
Candidates should have 5+ years of experience in related positions. A Bachelors Degree or higher is preferred.