Children's Medicaid Waiver Site Review Analyst

MPHI is a Michigan-based and nationally engaged, non-profit public health institute. We are a team of teams, process and content experts, dedicated to building A world where tomorrow is healthier than today!

Title: Children's Medicaid Waiver Site Review Analyst

$60,424 - $88,316.80 / Posted Thru: 6-9-25

Location: Remote/Virtual - Must Live and Work in Michigan

Purpose: As the Children's Medicaid Waiver Site reviewer, this position serves as site reviewer for assigned Prepaid Inpatient Health Plans (PIHPs) and Community Mental Health Services Programs (CMHSPs) reviews for compliance with 1915(c) Medicaid waivers Children's Waiver Program (CWP) and Serious Emotional Disturbance (SED) within the Bureau of Children's Coordinated Health, Policy, and Supports. This position must be knowledgeable about state and federal rules and regulations pertaining to PIHP's and CMHSP's. This position coordinates PIHP and CMHSP site reviews that focus on services for children and youth with developmental disabilities and children with serious emotional disturbances. It also supports development of written compliance reports generated as an outcome of the site reviews and conducts follow up related to remediation and plans of action.

Function as reviewer for Bureau site reviews of PIHPs and CMHSPs as it relates to contractual compliance with Medicaid Waivers and State Plan Services.

* Coordinate and communicate comprehensive site review schedule with applicable department and agency staff.

* In preparation for site reviews, review applicable PIHP, CMHSP documents (previous reviews, annual reports, remediation plans, etc.) and consult with department staff as needed.

* Coordinate and participate in travel to complete successful on-site reviews, as needed.

* Conduct entrance and exit conferences with the appropriate entities to communicate applicable information, including review of expectations and review findings.

* Review individual programs, person-centered plans, administration records, policies/procedures, and other applicable information/documents to ensure service delivery aligns with contractual requirements.

* Support Behavioral and Physical Health and Aging Services Administration's (BPHASA) preparation of written reports identifying specific findings and recommendations concerning corrective action/remediation.

* Make recommendations, as necessary, on corrective action and remediation plans.

* Coordinate with appropriate department entities, as needed, to improve PIHP compliance and performance.

* Provide education and technical assistance, as needed, regarding approaches to mental health services that best meet the needs of eligible individuals.

Analyze site review reports to determine trends of compliance and non-compliance among PIHPs and CMHSPs.

* Utilize professional expertise to analyze site review reports.

* Consult with MDHHS staff regarding outcomes/findings of surveys and other data collection methods.

* Draft reports and presentations as needed to communicate site review trends and findings.

* Recognize and report survey trends to agency staff, supervision and applicable MDHHS staff as needed or requested.

Design and implement applicable survey protocols, tools, and other methods to obtain specific data to determine PIHP and providernetwork compliance with state and federal laws, guidelines, and mandates.

* Work with applicable MDHHS staff to design surveys, protocols, tools, and methods to obtain specific data to determine PIHP and provider network compliance with state and federal laws, guidelines and mandates related to individual outcomes, such as health, safety, well-being, etc.

* Adjust survey protocols, tools and methods to meet specific needs of the department; communicate changes with the appropriate provider networks.

* Participate in special assignments/projects that relate to contract compliance activities or other activities to support the goals of the Bureau and department.

* Always represent the best interests of MDHHS and MPHI.

* All other duties as assigned.

Education: A bachelor's degree in social work, psychology, counseling, or other Human Services or Social Services field. A master's degree is preferred.

Experience:A minimum of one year of experience in delivering community-based mental health services to children/youth and their families is preferred.

Important Skills and Characteristics:

* Highly organized and strong attention to detail.

* Accurate and timely with reporting requirements (programmatic and fiscal).

* Team player, strength based and dependable.

* Self-motivated and able to work independently.

* Experience with Electronic Health Record Systems.

Work Environment and Physical Requirements: The office location of this position is 333 S Grand Ave., Lansing, MI 48933. Based on operational needs and within established limits, remote work and alternate or hybrid work schedule requests for this position may be considered. Standard office environment.

Selected candidates who have been approved to work remotely or a hybrid schedule must complete that work within Michigan. Candidates should confirm work location and schedule at the time of interview.

Employees will be provided with computers to perform state work. Phones may also be provided for necessary communications. If working remotely, employees will be responsible for providing other components of a remote office at their own expense, including:

* A secure work location that allows privacy and prevents distractions.

* A high-speed internet connection of at least 25 Mbps download and 5 Mbps upload.

* Suitable lighting, furniture, and utilities.

IMPACT ON PROJECTS, SERVICES AND OPERATIONS: This position has a direct impact on the quality of services provided by MPHI to MDHHS. This project is important to the Bureau of Children's Coordinated Health Policy and Supports as it supports the Medicaid waivers and network compliance.

"For purposes of employment standards, this classification is "Exempt" from overtime provisions of the fair Labor Standards Act."

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