Management Analyst 1 Developmental Disabilities Health and Human Services

Marion County requires on-site work. Remote work is not available.

Marion County Health & Human Services is looking for an organized detail-oriented motivated individual to join our Management Analyst team with our Intellectual and Developmental Disabilities department. This position will work closely with the Human Services Division leadership programs and internal & external partners to implement and monitor the divisions policies and procedures to ensure they reflect current and best practices regulations state and federal laws.

The successful candidate will have relevant educational and professional experience that demonstrates understanding of project coordination public policy experience supporting high performing diverse teams and making data driven decisions. Additionally the successful candidate will be able to demonstrate the ability to communicate clearly and collaboratively while managing competing priorities.

Individual Service Plan Review (ISP) and eXPRS Plan of Care (POC) authorization and data entry for SE& 257. EHR Action Request Form and Eligibility Enrollment Forms (DDEE/0337)

• Receive review and process all client ISP and change forms following detailed ISP processes. Data enter approved services and provider information as SPAs in POC. Process all employment in-home foster care and ancillary services from ISPs and Action Request Form (ARF). Stay current with POC process changes and any Office of Developmental Disabilities Services (ODDS) policy changes. Receive SE150 plans and verify that they may have the authorized services requested by Case Management.

• Receive ARF in Developmental Disabilities Management Analyst (DDMA) email submissions and complete necessary Raintree data entry of all client information and enrollments ticklers and then create and submit eXPRS DD Eligibility Enrollment (DDEE) electronic forms for all terminations and other changes. Problem-solve issues work with case managers to make corrections. Data enter Provider service code information and foster rates into eXPRS Service Prior Authorizations (SPA) in POC.

• Submit client address changes to ONE System.

DHS eXPRS System Oversight

• Monitor eXPRS to accept/process Service Element Prior Authorizations (SEPAs). Verify and record SEPAs in the SEPAs and Balances workbook for current Biennium. Confirm service element totals match what is recorded in eXPRS.

• Create eXPRS Client Prior Authorizations (CPAs) from the ISP or Change Form and submit. Upload Supported Living budget to the POC Audit and monitor draft CPAs in eXPRS and resolve discrepancies. Delete draft CPAs that are duplicates of approved CPAs for the same time period. Provide assistance to providers to resolve CPA and claim issues; refer to the DHS eXPRS Support team as appropriate.

• Monitor state General Fund service elements and notify Health Admin Contracts of needed contract actions and/or contract payments as relates to state General Fund SE156. Audit SE156 Provider Prior Authorizations (PPAs) to ensure funding has been received and payments to providers have been authorized.

Other Management Analysis QA Audits and Functions

• High-level complex analysis and modeling for DD program budgetary and contractual compliance.

• Act as Liaison between Community Development Disabilities Program (CDDP) and State of Oregon staff and contractors. Complete Safeguards Assessment Tool for monitoring on-going DD office HIPAA privacy compliance. Create electronic forms as requested. Run and distribute various DD reports using Raintree Reporting Services and eXPRS including the DD Client Services Population Report and others. Attend participate and work with other professionals on financial contract budgetary audit and DD Admin business committees provide system improvement recommendations as warranted.

• Read and understand ODDS Transmittals and ODDS Worker guides. Analyze impact of changes in Special conditions contract language and inform DD Program Manager or Supervisor. Provide quality assurance (QA) of documents such as Action Review forms budget documents and other documents. Complete Cherrylift Roster as needed and reconcile approved enrolled riders on the ridership report and review discrepancies submit rosters to Cherrylift and ODDS. Review and enter Long Term Care Community Nursing authorizations into MMIS.

• Provide training related to authorizing services in the Plan of Care identified within the Individual Service Plan as well as needed training needed to support quality assurance and quality improvement activities.

Oregon Needs Assessment (ONA)

• Review Service Group level when entering POC to ensure number of hours authorized on the ISP are within the range listed as determined by the ONA. Run and review ONA report to ensure tickler dates are updated and remove from ONA due list. Submit completed ONA billing report for Assessors to billing.

Residential Foster Home and Employment Provider Payment Issues

• Accept requests calls and e-mail from providers or Service Coordinators on the DDMA phone line and personal phone line regarding payment and non-payment issues. Review eXPRS and authorizations or submit inquiries to the ODDS eXPRS Technical Assistance Unit to ask about processing coding date problems payment issues denials suspension issues and other and then resolve CPA or SPA claims payment issues. Follow-up with the Service Coordinators and Providers.

Reconciliations and System Audits

• Audit claims reports for SE48 SE50 SE51 SE54. Reconcile and audit DD systems and service elements including eXPRS CPAs and SPAs ongoing to ensure proper reporting and tracking of client financial data. Complete other audits related to assigned Eligibility data PPAs ODDS 300% Rule or MAGI reports. Complete enrollment audits comparing eXPRS to Raintree to ensure the enrollments mirror each other and resolve discrepancies for service elementsand Cherriots. Audits are conducted quarterly until systematic issues are resolved but will continue to be conducted semi-annually to ensure the system is in check. Audit Overdue ONAs and ISPs and send report to supervisors monthly. Quarterly run eXPRS report to add the SE150 Family Support and send to Program Supervisor.

Case Management eXPRS Rationed Fee For Service (RFFS) Billing and Productivity Reports

• Generate Billing monthly report for Developmental Disabilities (DD) Program Supervisors. Export SE48 RFFS claims from eXPRS into Excel update/maintain the spreadsheet with Service Coordinator data funding and graphs.

• Run Payment Detail Report and/or RFFS billing from eXPRS and submit to Health Admin Finance for deposit. Enter RFFS claim payments on eXPRS Monthly Payments spreadsheet to track the number of claims paid. Submit report to HHS Administrator Program Manager and Program Supervisor.

Raintree Super User for DD

• Provide training and assistance to DD staff. Manage Raintree corrections and voids; create service tickets on an ad hoc basis.

EXPERIENCE AND TRAINING

1. Bachelors degree in public or business administration accounting or a related field; AND
2. Two years of responsible experience which includes independent research design and methodology and management analysis; OR
3. Any satisfactory combination of work education training or experience relevant to the position as determined by Marion County.

• The finalist for this position will be required to pass a criminal history background check; however conviction of a crime may not necessarily disqualify an individual for this position.
• This position may be subject to the following: Must not be excluded from participation in the federal health care programs (Medicaid Medicare and other federally funded programs that provide health benefits); AND must not be excluded from participating in federal procurement (Federal Acquisition Regulation) and non-procurement activities (Executive Order No. 12549).
• This assignment is represented by a union.
• This is a full-time position which is eligible for overtime.
• Typical Schedule: Monday - Friday 8:00 am - 5:00 pm with flexibility depending upon the needs of the department.

PUBLIC SERVICE LOAN FORGIVENESS
Marion County is a qualifying public employer for the Public Service Loan Forgiveness Program. Through the Public Service Loan Forgiveness Program full-time employees working at the County may qualify for forgiveness of the remaining balance on Direct Student Loans after 120 qualifying monthly payments under a qualifying repayment plan. Questions about your student loan eligibility should be directed to your loan servicer or the US Department of Education.

VISA SPONSORSHIP
Marion County does not offer VISA sponsorship. Within three days of hireyou will be required to complete the US Department of Homeland Securitys I-9 form confirming authorization to work in the United States. Marion County is an E-Verify employer and will use E-Verify to confirm that hires are authorized to work in the United States.

VETERANS PREFERENCE
Applicants are eligible to use Veterans Preference when applying with Marion County in accordance with ORS 408.225 408.230 and 408.235 and OAR and . Preference will be awarded only if the applicant meets the minimum requirements of the position and attaches the required documentation at the time of application.

DOCUMENTS REQUIRED FOR VETERANS PREFERENCE

• One of the following:
  • MEMBER COPY 4 of the Certificate of Release or Discharge from Active Duty (DD Form 214 or 215); OR
  • Letter from the US Department of Veterans Affairs indicating receipt of a non-service connected pension; OR
  • Certification that discharge or release from active duty under honorable conditions will take place not later than 120 days after the submission of the certificate.

• In addition to one of the above documents Disabled Veterans must also submit one of the following:
  • A copy of their Veterans disability preference letter from the Department of Veterans Affairs; OR
  • Certification that medical separation from active duty under honorable conditions will take place not later than 120 days after the submission of the certificate.

You can request copies of your military service record through the National Archives website at County is an Equal Opportunity Affirmative Action Veteran and Disability employer committed to increasing the diversity of its workforce.

Applicants with a disability may request reasonable accommodation through Human Resources in any step of the process to assist them in demonstrating their qualifications to perform the duties of the position for which they are applying. Please e-mailHuman Resourcesif you wish to request an accommodation.