Nc Medicaid Consultant

• Conduct an in-depth assessment to strengthen World Relief's capacity and program quality
• Collaborate with stakeholders to define specific goals and priority areas, assess the organization's viability for Medicaid managed care integration, and draft a detailed timeline and phased implementation plan
• Identify and collaborate with key stakeholders (e.g. NC Medicaid, Alliance Health)
• Draft a strategic plan tailored to the specific needs of the organization, outlining goals, priority areas, and a phased implementation timeline
• Conduct a thorough review of contracts, job descriptions, policies, procedures, workflow processes, communication structures, IT systems, reporting mechanisms, program management, billing procedures, and specialty services
• Provide holistic training for staff in critical areas such as workflow assessment, communication, IT systems, reporting, program management, and billing to ensure compliance and best practices
• Lead the collaboration with stakeholders to identify goals and priority areas
• Conduct analysis to assess World Relief’s current capacity and benchmarks to meet
• Develop a detailed timeline and phased implementation plan
• Craft a project schedule that outlines tasks, dependencies, and milestones to ensure a structured approach to the implementation process
• Provide comprehensive oversight from inception to conclusion
• Develop a detailed project plan delineating tasks, timelines, and resource allocation
• Support the review of contracts, job descriptions, policies, and procedures
• Collect and analyze data

Medicaid Expertise: Deep knowledge of NC Medicaid managed care, including eligibility criteria, billing codes, and reimbursement rates specific to mental health services for refugees and immigrants (specifically, interactive complexity and other related dynamics)

• Data Analysis and Reporting: Skills in collecting, analyzing, and reporting data to track program outcomes and meet NC Medicaid reporting requirements
• Familiarity with Electronic Health Records systems
• HIPAA and HITECH expertise to ensure that what is being set up is fully compliant
• Health Care Billing including 835 and 837 EDI files