Managerial, planning, administrative and supervisory work for the Department of Social Welfare involving claims processing and data collection for the Medicaid program. Duties include development of contract specifications and monitoring of contractor performance.
Supervision is exercised over a large staff of professional, technical and clerical subordinates.
Work is performed under the general direction of the Welfare Medicaid Director. Monitors and evaluates contractual claims processing systems used by all Vermont agencies participating in Medicaid, and including capitation payments. Develops standards for utilization review and quality assurance. Develops and implements third party liability programs, cost avoidance efforts, prior authorization and utilization review programs. Oversees a variety of consultants and contractual services.