IN-FSSA-Pregnancy Promise Program Project Specialist

Job Description

Purpose of Position/Summary: 

The mission of the Family and Social Services Administration (FSSA) is to compassionately serve Hoosiers of all ages and connect them with social services, health care and their communities. The agency includes the Office of Medicaid Policy and Planning (OMPP), a division that receives around 13 percent of the state’s budget to provide vital healthcare coverage to roughly 1 in 5 Hoosiers.

This position supports the grant-supported Pregnancy Promise Program, which helps pregnant individuals with substance use disorder (SUD) achieve sustained recovery and reduces neonatal abstinence syndrome in their offspring through three initiatives:

• Collaborative care coordination – With the State’s four Managed Care Entities (MCEs) and community health providers, develops collaborative problem-solving, shared best practices and innovative strategies for pregnant individuals with opioid use disorders (OUD).

• Provider Education – With the IU School of Medicine Project ECHO team, the Division of Mental Health and Addiction, and the Indiana State Department of Health Maternal and Child Health division, developed three educational tracks: obstetrical care of pregnant individuals with OUD, evidence-based neonatal abstinence syndrome management, and care coordination best practices for pregnant individuals with SUD.

• Addressing social determinants of health – Screens participants for social determinants and makes trauma-informed community referrals for identified needs.

The Project Specialist works closely with the Project Manager, FSSA Chief Medical Officer, and internal and external stakeholders. Medicaid members, families, providers and advocates are engaged at all stages. This high-profile State initiative addresses one of the Governor’s five pillars: attacking the drug epidemic and lowering infant mortality.

Essential Duties /Responsibilities:

• Help develop and revise project materials and outreach for referring agencies, including health care systems, human service agencies and community-based organizations

• Monitor, review and analyze performance outcomes and data quality for each of the four MCEs, and review biweekly MCE updates to ensure required CMS measures are met

• Ensure accurate data reaches OMPP so enrollment is reflected in CoreMMIS; work with OMPP on a CoreMMIS enrollment “check box” and on answering eligibility questions for potential enrollees

• Develop and revise MCE Complex Case Manager training materials

• Monitor and analyze performance and quality outcomes data for each MCE’s complex case management program; assist and give feedback to MCE project managers

• Help develop and deliver stakeholder presentations, traveling statewide to present to all provider types, at conferences and at other events

• Help write quarterly and annual CMS reports; with the Project Manager, track grant activities to meet report and budget timelines and assist with CMS documentation requests during the grant period

• Help develop a new statewide MCE Complex Case Manager Best Practices Forum, collect quality improvement data, and facilitate implementation of new standard procedures

• Research, draft and disseminate complex case management best practice guidelines; draft a program manual, updated at least annually, covering guidelines, data requirements, case management practices, etc.

• Ensure grant funds are allocated per federal, state and grant guidelines and financial reports are submitted on time per federal requirements

• Address implementation barriers through field visits with MCE and community provider case managers, with problem-solving and feedback loops

• Develop agendas and coordinate cross-sector participants for regional meetings and MOM grant listening tours in the State’s five Medicaid regions

• Serve as liaison to enrollees, community mental health center staff, referral sources and project partners; answer emails, calls and texts from enrollees, MCE care coordinators and other providers within 2 business days, providing program guidance

• Help develop the public-facing website of resources for members, loved ones and providers; review it for updates and work with the communications team on changes

• Manage website referrals: confirm Medicaid coverage/eligibility and route to the correct MCE

• Obtain and maintain Indiana Navigator licensure (8 hours of training, provider quiz, IDOI exam)

• Complete Medicaid applications for potential enrollees without coverage, with continuous outreach through 90 days postpartum

• Make all program materials as equitable and inclusive as possible; collaborate with Indiana 211 for members who are not eligible for the program

• Resolve disputes between MCE and community case managers; support and assist managed care case managers on individual client issues and best practices

• Coordinate with the Project ECHO Coordinator on curriculum, presenters and scheduling for case managers and community health workers serving the target population

• Work with the data and analytics team on developing an FSSA data app

• Record thorough, accurate minutes at all meetings for FSSA colleagues, MCEs and stakeholders

• Analytical, with keen attention to detail while keeping the broader picture and message in view

• Ability to resolve issues with professionalism and sensitivity and work well with other agencies and divisions

• Ability to use standard word processing, spreadsheet and database programs; compile, synthesize and present complex recommendations; and

• Passion for public service

Job Requirements: 

• Bachelor’s degree in social work, public health, public administration or similar; 4–5 years of healthcare or compliance experience may substitute

• Experience managing federal or state grants, including budget oversight

• Knowledge of state and federal laws, regulations and policies related to addiction treatment

• Ability to identify, analyze, summarize and communicate information, orally and in writing, and formulate recommendations

• Skill in coordinating work with agency staff, advisory groups and committees to achieve desired outcomes

• Ability to work effectively with diverse stakeholders, including individuals with lived experience, family members, advocates and mental health/addiction providers

• Knowledge of planning, program development and evaluation methods

• Flexible, creative, assertive and able to work in a multitask, multidisciplinary environment

• Expertise working with culturally diverse, at-risk populations

• Extensive understanding of Medicaid, waiver services and managed care, and extensive knowledge of state laws, policies and procedures pertinent to Medicaid programs

• Knowledge of care coordination and case management (prior experience preferred)

Supervisory Responsibilities/Direct Reports:

None

Difficulty of Work:

Work is complex, integrating diverse programs and policies across numerous federal and state agencies and requiring thorough understanding of legal, political, social justice, child welfare, medical and behavioral health parity and equity, and organizational issues. The position involves unprecedented coordination among programs affecting maternal and infant health within FSSA and other agencies, including the Department of Health and DCS. As the grant is new, the role requires innovative thinking, initiative and creativity in designing methods to solve new, complex problems. Must balance the program’s long-term goals, managed care principles, political climate, and existing policies, laws, waivers, rules and regulations. Must know evidence-based and promising practices for pregnant women with OUD and infants with neonatal abstinence syndrome; be knowledgeable of home visitation programs and case management competencies; understand implicit bias, ethics and boundaries; create individualized care plans to improve outcomes for MOM enrollees; and be willing to use an implementation science framework for plan, do, study, act quality improvement/system building. Work is both strategic and tactical, requiring flexibility and creativity to set guidelines and priorities and maintain operations. Must resolve conflicts between partners, sometimes in an adversarial environment.

Responsibility:

Working with the Project Manager, Chief Medical Officer and agency leads, the Project Specialist works with a high degree of independence under general guidance; new situations are discussed as needed. Work is reviewed for attainment of project and agency goals and compliance with federal and state requirements. Must formulate solutions and confer with the supervisor on highly complex and sensitive projects. Faulty recommendations could harm Medicaid members, the program or agency credibility, or cause loss of federal funding.

Personal Work Relationships:

Relationships are with the supervisor, quality and contract compliance staff, FSSA and State Department of Health staff, contractors, federal and state officials, health organizations and the public, to coordinate the program, share information and resolve program issues; also closely with insurance and community care coordinators and grant enrollees.

Physical Effort:

No unusual physical effort required; may occasionally lift up to 10 lbs. Extended computer use is required. Must attend meetings at various locations throughout the Government Center and off-site locations statewide.

Working Conditions:

Standard office environment. Some in-state travel required for meetings or public speaking engagements. May require extended time beyond the standard workday during high-volume seasons/operations.