Job Specification Details

Work is performed under the general direction of the Department of Vermont Health Access (DVHA), Health Reform Enterprise Director II. Work involves establishing and enhancing relationships and networking of Federal, State and Vendor connections and enhancing those relationships. This Certification work ensures that the State receives increase Federal Financial Participation (FFP) funding from 50/50 Federal/State to a 75/25 Federal/State for ongoing Maintenance and Operations expenses related to Medicaid funding. 

This work could include developing communication and strategic planning protocols, keeping updated 'white papers' describing each vendor, facilitating collaboration in areas where vendors are engaged along with taking a leadership role in how DVHA engages Federal partners and vendors. The work requires an articulate, dynamic, and proven leader able to work with a variety of vendors and State staff to build a robust networking environment that promotes close working partnerships. This work involves interacting with a broad view of Agency staff including but not limited to: Business Office, Secretary's Office and Commissioners as well as Agency of Digital Services (IT). This role adheres to the AHS Four Key Practices of: customer service, holistic service, strengths-based relationships and results orientation.

Assists the DVHA Commissioner staff in ensuring and enhancing healthy relationships with Federal Partner and vendors. This includes information is coordinated in an organized and reliable fashion that promotes the building of strong partnerships related to Vermont health reform initiatives. Work collaboratively with the Health Reform team to ensure consistent, timely rollout of information in a two way fashion. First, this individual will provide State staff with necessary background/guidance on Federal partners and vendors in relation to the efforts at hand. Second, this person will provide 'just in time' information to the Vendor community that is clear and concise about the direction the State is taking and/or requesting any information. Making use of all available communication tools including social networking tools, being sure to adhere to all appropriate security and privacy requirements. Participate as a core member of the Health Reform Division. Work with DII, AHS partners and State marketing personnel to ensure consistency of communication and be able to serve as a translator of the work projects to Vendors and Departmental leadership. Provide leadership in communication across Departments regarding DVHA Portfolio projects. Act as liaison providing information and communication about various phases of Health Reform and transformation. Provide translation and support for communication materials about Vermont's integrated Health Reform initiatives, as well as Medicaid Management Information System (MMIS) initiatives for a variety of target audiences, including health care providers, the general public, executive branch leadership, and the Legislature. Engage existing networks and develop new networks in order to engage individuals and groups in communication around business and IT aspects of Health Reform. These 'individuals' and 'groups' could be either expanding State staff networks or they could be expansion of the Vendor network. Contribute to written reports and website updates as required. Be available to attend off-site meetings and conferences with Vendors, being sure to represent the State in a professional, courteous and respectful manner. Work closing with CMS partners to obtain Certification for projects that meet certification criteria. 

Will need to assess and do an analysis with projects in order to track any changes in scope, outcomes, metrics. Will need to review tracking and comparing key performance indicators, (KPIs) to identify and address issues with productivity, reimbursement, claims submission, and other processes.

Will be able to work with a strategically implemented a comprehensive three-part certification workstream, including PRQCERT, CERT, and POST CERT, to streamline a certification processes in order to guarantees alignment with Federal requirements, Conditions for Enhanced Funding, MTA Standards and Conditions and Industry Best Practices.

Will be able to work closely with Federal Partners regarding CMS’s Streamlined Modular Certification process, to ensure Vermont optimizes the path to successful certification attainment. Which ultimately leads to more efficient and effective program implementations.

Performs related duties as required.

Duties are performed primarily in a standard office setting. Private means of transportation must be available for occasional travel. The incumbent must be able to grasp a broad array of projects and vendor interests and be able to organize the information and convey it in a coherent manner (written and/or oral). Some pressure from deadlines is anticipated.

Comprehensive knowledge of the health care delivery system in Vermont.

Comprehensive knowledge of current issues and trends in health, public health and health care, at the state and federal level.

Considerable knowledge of building vendor relationships.

Awareness of various vendor types and how to best organize, communicate and enhance the relationship with vendors.

Comprehensive knowledge of health care industry vendors

Considerable knowledge of means to build and enhance vendor communication using new technology and social media as health care enterprise development moves along in a fast and agile approach.

Ability to use research/evaluation principles and procedures.

Ability to comprehend project goals and strategic initiatives and determine that best course of action to engage and collaborate with vendors.

Ability to function and work independently, with an entrepreneurial and dogged spirit within the framework of a team.

Strong, positive, communication skills and ability to speak in public to present clear and concise reports.

Ability to establish and maintain effective working relationships and communicate orally and in writing.

Three (3) years or more in Medicaid related work or eligibility determination.