LOCATION: Remote – this is a home-based, virtual position that operates within the hours of 8:30am-5:00pm EST. Incumbent must live in North Carolina or within 40 miles of the NC border.
GENERAL STATEMENT OF JOB
The employee serves as an internal and external resource that knows services available in the network, actively pursues, addresses and fills gaps in Opioid treatment services. The employee partners with internal work teams, often leading such project teams, to assure access to Opioid treatment and recovery programs across the Vaya network. The employee ensures that engagement with contracted providers is consistent and in line with contract obligations. This position will be focused on funded initiatives focused on Opioid use disorder. The primary purpose of the position is to ensure that there is coordination among the various streams of federal funding coming into the organization to address the opioid crisis. This position will serve as a key team member in administering and coordinating the implementation of federal grants within Vaya that focus on various aspects of the opioid epidemic.
ESSENTIAL JOB FUNCTIONS
Opioid and Substance Use Disorder Specific:
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Manage, oversee and implement the WNC Substance Use Alliance regional plan
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Oversee, coordinate and monitor all grants received by Vaya related to the opioid crisis and other substance use disorder initiatives
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Develop and maintain project management tools to track grant project/program funding and work plans, including fiscal and administrative reporting timelines and deliverables
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Provide reports that describe the intent, deliverables and outcomes of each opioid and substance use disorder grants; Assure opioid and substance use grants are implemented as per grant, state and federal requirements
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Collaborate in the development of project policies, protocols and procedures to ensure compliance with reporting timelines and deliverables
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Provide support and coordination for the preparation of grant proposals, reports and presentations, including those for funders and stakeholders
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Ensure administrative tasks associated with grant accounting, contracts and budgets adhere to state and federal standards and requirements
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Participate in the development, implementation and coordination of federal grant evaluation and data collection protocols
Network Management:
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Function as the single point-of-contact for all on-going contractual and service issues as assigned
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Negotiate and re-negotiate specialty provider organization contracts
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Complete assigned elements of gaps analysis ensuring completion of assigned elements by date identified each calendar year and present information to internal and external stakeholders as assigned
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Complete assigned elements of annual network development plan ensuring completion of assigned elements by date identified each calendar year and present information to internal and external stakeholders as assigned
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As assigned, liaison with disability specific Provider Advisory Council subcommittees on gaps analysis/network development plan and establish due dates for information sharing
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Participate in development of provider operational manuals and educational materials that are tied directly to established clinical coverage policies as assigned
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Update internal policies and procedures as assigned
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Lead development of network training initiatives and manage coordination with external education vendors as assigned
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Provide expertise for stake holders groups mandated by contract and as assigned
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Develop, direct, support, and oversee initiatives specific to substance use disorder
Other Duties as Assigned.
KNOWLEDGE, SKILL & ABILITIES
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Expert knowledge on Substance Use addiction treatment with a concentration on Opioid related treatments
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Expert level of knowledge of Center for Medicare and Medicaid Services (CMS) reimbursement methodologies
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Knowledge of the assessment and treatment of mental health, developmental disabilities, and substance use disorder, sometimes co-occurring
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High level of knowledge of Microsoft Office applications and adept at learning software applications – expert level preferred
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Highly motivated, team player, self-starter and able to work independently with little or no direction
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Ability to exercise discretion and make independent decisions without supervisory input on matters of significance
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Proficiency in analyzing, understanding, and communicating network needs
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Strong customer service skills paired with a positive demeanor – a “can do” attitude
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Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others, including but not limited to reimbursement policy standards
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Exceptional business acumen
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Ability to present to varied audiences on various disability topics
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Ability to manage multiple priorities in a fast-paced environment
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Prior demonstrated success in provider relations or relations with both large provider groups and/or ancillary providers
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Experience with multiple relations methodologies such as RVRBS, flat rates, case rates, and per diems and tiered rates based on the intensity of service helpful
QUALIFICATIONS & EDUCATION REQUIREMENTS
Master’s degree in a Human Services field required. Must have 2-5 years relevant Substance Use treatment and/or recovery focused experience.
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5+ years of experience in a network management-related role handling complex network providers in the health care industry with accountability for business results preferred.
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Experience with capitation contracts and 5+ years of experience utilizing financial modeling in making rate decisions preferred.
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5+ years of experience developing and managing a medical cost and administrative budget preferred.
Licensure/Certification Required:
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License or license eligible in NC required. Preferred license categories are LCSW, LCAS, and/or LMHC
PHYSICAL REQUIREMENTS
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Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
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Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers.
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Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
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Mental concentration is required in all aspects of work.
RESIDENCY REQUIREMENT: This position is required to reside in North Carolina or within 40 miles of the North Carolina border.
SALARY: Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.
DEADLINE FOR APPLICATION: Open Until Filled
APPLY: Vaya Health accepts online applications in our Career Center, please visit https://www.vayahealth.com/about/careers/.
Vaya Health is an equal opportunity employer.