Indigent Health Care Director

SUMMARY : This position is responsible for the overall supervision and execution of the Rockwall County Indigent Health Care program. This program involves proper implementation and adherence to Chapter 61, Health and Safety Code, County Indigent Health Care Program Handbook, federal, state and local laws and regulations. The Director is responsible for program administration, accounting of program budget, medical claim audits, developing and implementing program policies and procedures, determining eligibility and navigating clients to various services.

ESSENTIAL JOB FUNCTIONS :

• Plan, develop, implement and maintain policies and procedures for operations of the Indigent Care Program while adhering to Chapter 61, Health and Safety Code and the County Indigent Health Care Program Handbook in addition to federal, state and local laws and regulations.
• Review and verify data on applications by confirming information with financial instructions, landlords, social media, various human services agencies, employers, etc.
• Interview new applicants and continual eligibility for clients for Indigent Health Care services.
• Receive, investigate, and respond to complaints regarding applicants, clients and / or providers.
• Maintain casework files documenting how eligibility was determined; review case files for accuracy, possible third party payers and fraud detection; follows mandated time elements for eligibility; review appeals; process letters of denial and monitor the pending status of potential clients.
• Report to Commissioner's Court on upcoming legislation changes that may impact county programs or the departmental budget.
• Update and manage current database for all county indigent clients, detention center inmates receiving inpatient / outpatient medical services and for medical providers.
• Audit medical claims for accuracy, Medicaid discounts, duplicate charges / payments and third party coverage.
• Approve indigent medical claims for payment and generate reports for the auditor's office.
• Review and process medical claims billed to the Rockwall County Detention Center inmates for accuracy, duplicate charges / payments, third party payers and Medicaid discounts.
• Confer with representatives of other governmental programs, private human service agencies or health care professionals to coordinate referrals for program clients or needed services.
• Administer the Indigent Health Care Program budget; monitor / approve expenditures, process accounts payable / receivable and general ledger monitoring,
• Manage routine personnel matters such as recruiting, interviewing, hiring, training, scheduling, disciplining and retaining employee files.
• Receive and investigate complaints and inquiries pertaining to staff, clients, providers and program operations by conferring with parties involved, reviewing documentation, preparing verbal / written resolutions and / or recommendations.
• Consult with the County Attorney in fraudulent cases and other legal matters pertaining to the program.
• Submit Indigent Health Care financial reports to Texas Department of State Health Services.
• Maintain compliance with HIPAA policies; maintain client confidentiality.
• Present information to civic groups, businesses, and various other community service organizations; maintain professional affiliations and enhance professional growth and development to stay abreast of latest trends in healthcare administration.
• Serve on boards and attend meetings; communicate with other department heads and elected officials to determine cost savings initiatives and provide superior customer service to residents of Rockwall County.
• Performs other duties as assigned.

SUPERVISORY / BUDGET RESPONSIBILITIES :

This position has supervisory responsibility over one position. This position has full responsibility for the development and control of the departmental budget.

KNOWLEDGE, SKILLS, AND ABILITIES :

MINIMUM QUALIFICATIONS :

WORKING CONDITIONS :

Position is located in an office environment with little or no exposure to environmental conditions. Health and safety hazards are minimal. No protective equipment is required. Fine dexterity, sitting, handling, and vision are constantly required. Hearing and talking are frequently required. Occasional walking and reaching are required.

CONDITIONS OF EMPLOYMENT :