Medicaid / Waiver Program Coordinator

Medicaid Waiver Program Coordinator CommonSail Investment Group Position Summary The Government Programs & Reimbursement Coordinator is responsible for the coordination research application processing compliance tracking and billing oversight for Medicaid waiver participation across StoryPoint Group assisted living and memory care communities and CorsoCare Personal Care in multiple states This role serves as the internal subject matter resource for Home and Community Based Services HCBS waivers state specific Medicaid programs VA GUIDE program and other government payor type programs The Coordinator ensures timely enrollment accurate documentation regulatory compliance and proper billing processes to support operational success and revenue integrity This position works cross functionally with Compliance Operations Clinical Finance and Revenue teams to support sustainable waiver participation aligned with our Safety First commitment and regulatory excellence standards Required Experience for Government Programs & Reimbursement Coordinator Education Bachelors degree preferred Healthcare Administration Business Public Health or related fieldExperience 25 years experience in healthcare administration Medicaid programs senior living or long term careProgram Knowledge Familiarity with Medicaid waiver or managed care programs preferredRegulatory Knowledge Multi state regulatory exposure preferredBilling Knowledge Experience with healthcare billing processes strongly preferred Primary Responsibilities for Government Programs & Reimbursement Coordinator Research & Program Tracking Research state specific Medicaid waiver requirements and program updatesMonitor changes to HCBS regulations and state waiver amendmentsMaintain a multi state waiver tracking matrix includingEnrollment statusRenewal deadlinesRequired documentationManaged care participationPrepare summaries of regulatory updates for leadership review2 Application & Enrollment Coordination Coordinate and prepare Medicaid waiver provider enrollment applicationsCollect required documentation from communities and corporate departmentsTrack submission timelines and follow up with state agencies and MCOs as applicableMaintain organized records ofProvider enrollmentsCredentialing approvalsAttestationsSite readiness inspectionsServe as point of contact for state Medicaid agencies during application processes3 Compliance Monitoring Maintain waiver compliance checklists for participating communitiesTrack required documentation such asService plansEligibility verificationStaffing requirementsHCBS setting compliance attestationsSupport internal audits and assist with corrective action trackingCoordinate documentation for state audits or desk reviewsMaintain waiver policies and procedures library4 Billing & Revenue Coordination Collaborate with Revenue Cycle and Finance teams toEnsure waiver billing processes are properly implementedConfirm documentation supports billed servicesTrack denials or payment discrepanciesMaintain waiver billing logs and reconciliation reportsAssist with investigation of billing issues or recoupment concernsDevelop tracking tools to monitor billing accuracy and timeliness5 Operational Support & Training Support communities in onboarding waiver residents byProviding documentation guidanceReviewing required formsClarifying service requirementsAssist in development of waiver training materials forExecutive DirectorsWellness DirectorsProperty AdministratorsProvide ongoing support for waiver related questions from field teams6 Reporting & Communication Maintain centralized dashboardsPrepare monthly status reports onEnrollment activityCompliance metricsBilling trendsEscalate risks or compliance concerns to leadershipParticipate in cross functional meetings related to Medicaid and reimbursementAccountability Metrics Timely and accurate submission of waiver applicationsZero missed enrollment or renewal deadlinesBilling accuracy rate in collaboration with Revenue CycleAudit documentation readinessReduction in waiver related denials or recoupmentsAccurate tracking of waiver participation across all statesSkills for Success Building solid cross functional relationships aligned with the organizations 1440 Care StandardsStrong organizational skillsRegulatory research capabilityAttention to detailProject coordinationFinancial and billing awarenessCross functional communicationDeadline managementTravel Minimal to moderate travel as needed for state inspections or operational support General Working Conditions This position involves frequent standing sitting and walking The employee will regularly communicate effectively handle keyboards telephones and documentation Occasional lifting of up to 25 pounds may be required Occasional travel to community locations is expected The work environment involves moderate noise levels and requires positive interaction with colleagues and residents Equal Opportunity Employer StoryPoint Group is committed to fostering a culture of excellence safety and continuous improvement in all areas of resident care CSALL