Department: Case Management
Location: Tampa, FL
Reports To: Dir, Product Operations
Develop and implement a consumer directed program and vendor oversight model geared toward continuous monitoring and oversight of the Fiscal Employer Agent (F/EA) / Fiscal Intermediary (FI) specifically related to the consumer directed/participant direction option (PDO) care model within managed long term care. Responsibilities include but not limited to: Ensures policies and processes are developed and maintained that will hold vendors to meeting or exceeding contractually required performance and service levels. Proactively identify areas of risk and implement action plans to resolve in order to maintain Contract compliance with the consumer directed option of care. Drive resolution of vendor performance that does not meet contractual performance measures or service level agreements through developing and implementing corrective action plans. Collaborates with MLTSS care management team related to over/under utilization of consumer directed services, member satisfaction, and vendor service delivery. Serves as the subject matter expert for the consumer directed model of care.