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About the Role

The Office of Aging & Long-Term Care is seeking a Medicaid Program Manager to support the Center for Home and Community Based Services in its mission to rebalance New York State's long-term care system. This position plays a critical role in supporting the Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI) Medicaid Waiver Programs, ensuring compliance with CMS requirements, and overseeing participant complaint resolution, quality assurance, and stakeholder engagement.

Responsibilities

Oversee and manage quality assurance activities for the NHTD and TBI Waiver Programs.
Lead the waiver participant complaint process, ensuring timely investigation and resolution of concerns.
Serve as the primary point of contact for waiver participant cases.
Investigate participant complaints, critical incidents, abuse, neglect, and participant harm allegations.
Collaborate with Regional Resource Development Centers (RRDCs), Service Coordinators, and provider agencies to address and resolve participant concerns.
Ensure waiver program compliance with federal CMS standards and regulations.
Interact with CMS staff and external stakeholders regarding waiver operations and regulatory requirements.
Monitor program performance and identify opportunities for continuous quality improvement.
Provide technical assistance and guidance to RRDCs, program service agencies, and internal Department of Health teams.
Interpret and clarify waiver policies, procedures, and program manuals.
Identify opportunities for stakeholder education and participant engagement.
Serve as a liaison across Department of Health bureaus to support coordinated program operations.
Conduct periodic reviews of waiver service quality and participant outcomes.
Develop reports, recommendations, and program analyses for leadership.
Identify operational efficiencies and process improvement opportunities.
Facilitate meetings and present findings to internal and external stakeholders.

Requirements

Bachelor's degree and equivalent professional experience, or a combination of education and experience.
10+ years of professional experience in healthcare administration, Medicaid programs, human services, long-term care, public health, or a related field.
5+ years of subject matter expertise in Medicaid, waiver programs, managed care, healthcare compliance, or related program operations.
Demonstrated supervisory or team leadership experience.
Experience managing complex investigations, case reviews, compliance activities, or quality assurance initiatives.
Experience with Home and Community-Based Services (HCBS), Medicaid Waiver Programs, NHTD, TBI, or long-term services and supports (LTSS).
Knowledge of CMS regulations and Medicaid program requirements.
Strong written and verbal communication skills.
Excellent organizational, analytical, and problem-solving abilities.
Experience facilitating meetings and collaborating with diverse stakeholder groups.
Advanced proficiency with Microsoft Office Suite, including Word, Excel, and PowerPoint.
Ability to prepare detailed reports, executive summaries, and presentations for leadership.
Applicants must be authorized to work in the U.S.
This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO.
This position is not eligible to support a STEM EAD extension application.

Skills

Healthcare administration
Medicaid programs
Human services
Long-term care
Public health
Medicaid waiver programs
Managed care
Healthcare compliance
Program operations
Supervisory experience
Team leadership
Investigation management
Case review
Compliance activities
Quality assurance
Home and Community-Based Services (HCBS)
Nursing Home Transition and Diversion (NHTD)
Traumatic Brain Injury (TBI)
Long-term services and supports (LTSS)
CMS regulations
Written communication
Verbal communication
Organizational skills
Analytical skills
Problem-solving
Meeting facilitation
Stakeholder collaboration
Microsoft Office Suite
Report preparation
Executive summaries
Presentation development

Location

Albany, NY

Work Type

Hybrid (50% Onsite / 50% Remote)

Experience Level

10+ years of professional experience
5+ years of subject matter expertise
Demonstrated supervisory or team leadership experience

Education Level

Bachelor's degree

Salary/Compensations

$85,000 - $93,600

Benefits

Medical insurance
Dental insurance
Vision insurance
401(k) with discretionary employer match
Paid time off
Holidays
Flexible spending accounts
Additional employee perks

About the Company

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services.
SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Equal Opportunity

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability.
Staffing Solutions Organization LLC is an E-Verify participant.