Talent.com
NC Medicaid Consultant
NC Medicaid ConsultantWorld Relief • Durham, North Carolina, United States, 27701
[error_messages.no_longer_accepting]
NC Medicaid Consultant

NC Medicaid Consultant

World Relief • Durham, North Carolina, United States, 27701
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

NC Medicaid Consultant

Are you a person of compassion? An advocate for justice? Someone who stands up for the rights of the vulnerable and speaks out for the marginalized, the exploited and the forgotten? Do you believe in our calling as Christians to welcome the least of these and love our neighbor?

If you answered yes, to any of the above, World Relief, and millions of people around the world need you.

At this pivotal moment in time, we are rapidly expanding and growing our team to meet the increasing needs of our world. We are looking for people who want to use their gifts and talents to make a real and tangible difference in our world and the lives of the suffering. If youre looking for a purpose-driven career in which you can grow your talents, while also standing up for the rights of the vulnerable, we want you to join us today. ORGANIZATION SUMMARY : World Relief is a global Christian humanitarian organization whose mission is to boldly engage the worlds greatest crises in partnership with the church. The organization was founded in the aftermath of World War II to respond to the urgent humanitarian needs of war-torn Europe. Since then, for 80 years, across 100 countries, World Relief has partnered with local churches and communities to build a world where families thrive and communities flourish.

Today, organizational programming focuses on humanitarian and disaster response, community strengthening and resilience, and refugee & immigrant services and advocacy.

POSITION SUMMARY :

World Relief Durham is seeking proposals for a Lead Consultant to assist with effective implementation and growth of NC Medicaid managed care services, offer assessment and strategic planning services, in collaboration with other key stakeholders to be identified.

Responsibilities :

  • The ideal scope of work to include :
  • Conduct an in-depth assessment to strengthen World Relief's capacity and program quality.
  • Collaborate with stakeholders to define specific goals and priority areas, assess the organization's viability for Medicaid managed care integration, and draft a detailed timeline and phased implementation plan.
  • Identify and collaborate with key stakeholders (e.g. NC Medicaid, Alliance Health).
  • Draft a strategic plan tailored to the specific needs of the organization, outlining goals, priority areas, and a phased implementation timeline.
  • Conduct a thorough review of contracts, job descriptions, policies, procedures, workflow processes, communication structures, IT systems, reporting mechanisms, program management, billing procedures, and specialty services.
  • Provide holistic training for staff in critical areas such as workflow assessment, communication, IT systems, reporting, program management, and billing to ensure compliance and best practices. Proposed tasks to include :
  • Lead the collaboration with stakeholders to identify goals and priority areas.
  • Conduct analysis to assess World Reliefs current capacity and benchmarks to meet.
  • Develop a detailed timeline and phased implementation plan.
  • Craft a project schedule that outlines tasks, dependencies, and milestones to ensure a structured approach to the implementation process.
  • Provide comprehensive oversight from inception to conclusion.
  • Develop a detailed project plan delineating tasks, timelines, and resource allocation.
  • Support the review of contracts, job descriptions, policies, and procedures.
  • Collect and analyze data

Requirements :

  • Medicaid Expertise : Deep knowledge of NC Medicaid managed care, including eligibility criteria, billing codes, and reimbursement rates specific to mental health services for refugees and immigrants (specifically, interactive complexity and other related dynamics).
  • Preferred Qualifications :

  • Data Analysis and Reporting : Skills in collecting, analyzing, and reporting data to track program outcomes and meet NC Medicaid reporting requirements.
  • Familiarity with Electronic Health Records systems. Although we have already selected Ritten as our EHR, the consultant should be proficient with and able to advise on how it can best integrate with workflows, billing, reporting, and data management.
  • HIPAA and HITECH expertise to ensure that what is being set up is fully compliant.
  • Health Care Billing including 835 and 837 EDI files. The consultant should help establish efficient billing processes for NC Medicaid mental health services. They should guide in implementing and managing 837 electronic claim submissions and 835 electronic remittance files. The consultant should help develop procedures for "scrubbing" claims before submission to ensure accuracy and reduce claim denials. They should also assist in developing a system for managing claim denials and appeals.
  • PI1210b24080e7-30511-38893270

    [job_alerts.create_a_job]

    Consultant • Durham, North Carolina, United States, 27701

    [internal_linking.similar_jobs]
    Travel MRI Tech - $2093.36 / Week

    Travel MRI Tech - $2093.36 / Week

    FlexCare • Chapel Hill, NC, US
    [job_card.full_time]
    FlexCare is seeking an experienced MRI Tech for an exciting Travel Allied job in Chapel Hill, NC.Shift : 3x12 hr days Start Date : 01 / 05 / 2026 Duration : 13 weeks Pay : $2093. Level I Trauma and Teaching...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel MRI Tech - $1,671 to $1,921 per week in Chapel Hill, NC

    Travel MRI Tech - $1,671 to $1,921 per week in Chapel Hill, NC

    Fusion Medical Staffing • Chapel Hill, NC, US
    [job_card.full_time]
    Facility in Chapel Hill, North Carolina.Fusion Medical Staffing is seeking a skilled MRI Tech for a 13-week travel assignment in Chapel Hill, North Carolina. As a member of our team, you'll have the...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel Medical Technologist - $1,514 to $1,659 per week in Roxboro, NC

    Travel Medical Technologist - $1,514 to $1,659 per week in Roxboro, NC

    AlliedTravelCareers • ROXBORO, NC, US
    [job_card.full_time]
    AlliedTravelCareers is working with AMN Healthcare Allied to find a qualified Medical Technologist in ROXBORO, North Carolina, 27573!. Job Description & Requirements.Medical Technologist - Clini...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Med Tech

    Med Tech

    Phoenix Senior Living • Durham, NC, United States
    [job_card.full_time]
    Seasons at Southpoint is seeking Med Techs to join their team!.Med Tech / Certified Medication Aide.The Med Tech is responsible for monitoring the health and well being of our residents and provide...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Internal Medicine Physician Needed for Locum Tenens Coverage at Facility in Greenville, North Carolina

    Internal Medicine Physician Needed for Locum Tenens Coverage at Facility in Greenville, North Carolina

    HealthEcareers - Client • New Hill, NC, USA
    [job_card.full_time]
    Job Reference Id : ORD-206161-MD-NC.Dates Needed : January - Ongoing weekend coverage.Board Certification Required : Negotiable. A state hospital is seeking an internal medicine physician for locum ...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Behavioral Health Consultant II (School Based) - 10 Month Role

    Behavioral Health Consultant II (School Based) - 10 Month Role

    Piedmont Health Services • Chapel Hill, NC, US
    [job_card.full_time]
    About Piedmont Health Services.PHS) is a 501(c)(3) nonprofit and Federally Qualified Health Center (FQHC) in North Carolina. Dedicated to delivering top-tier, accessible, and inclusive primary healt...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Strategic Client Consultant II - Major Markets

    Strategic Client Consultant II - Major Markets

    Blue Cross and Blue Shield of North Carolina • Chapel Hill, NC, United States
    [job_card.full_time]
    Responsible for delivering consistent, profitable Blue Cross NC Major Group sales, by promoting current group retention and sale of new product lines to existing clients, in support of the goals an...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Business Consultant Unique III

    Business Consultant Unique III

    Katalyst Healthcares & Life Sciences • Durham, NC, US
    [job_card.full_time]
    Value & Access Analytics & Operations Contractor.We are seeking a highly skilled and detail-oriented Value & Access (V&A) Analytics & Operations contractor to join the Value & Access team within Me...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Sales Consultant

    Sales Consultant

    Easy Step Enterprises LLC • Chapel Hill, NC, US
    [job_card.full_time]
    Selling stuff is easy, but transforming lives is a unique challenge.If you want easy, this isn’t for you.But if you’re ready to embrace changing lives, creating opportunities for yourse...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Internal Medicine

    Internal Medicine

    Enterprise Medical Recruiting • Durham, North Carolina, US
    [job_card.full_time]
    Internal Medicine physician job in North Carolina : .Join a rapidly growing, innovative company of community-based healthcare centers delivering higher quality health and wellness care that improves...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Emergency Medicine Physician Needed for Locum Tenens Coverage at Facility in Roxboro, North Carolina

    Emergency Medicine Physician Needed for Locum Tenens Coverage at Facility in Roxboro, North Carolina

    HealthEcareers - Client • New Hill, NC, USA
    [job_card.full_time]
    Job Reference Id : ORD-201958-MD-NC.Dates Needed : October 1 - Ongoing.Board Certification Required : Negotiable.A facility is seeking an Emergency Medicine Physician for locum tenens coverage.The ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Correctional Medicine Physician

    Correctional Medicine Physician

    MSI Systems Corp, DBA Medical Search International • Not Specified, NC, USA
    [job_card.full_time]
    North Carolina (40 mins east of.Internal Medicine / Family Medicine / Urgent Care / Primary Care.NC license, Active DEA, Board Certified / Eligible in related specialty. Travel, lodging (if needed), a...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel CT Tech - $1,993 per week in Roxboro, NC

    Travel CT Tech - $1,993 per week in Roxboro, NC

    AlliedTravelCareers • Roxboro, NC, US
    [job_card.full_time]
    AlliedTravelCareers is working with FlexCare to find a qualified CT Tech in Roxboro, North Carolina, 27573!.FlexCare is a nationwide leader in the staffing of travel nurses and clinicians.With acce...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Travel MRI Tech - $1,847 per week in Chapel Hill, NC

    Travel MRI Tech - $1,847 per week in Chapel Hill, NC

    Triage Staffing LLC • Chapel Hill, NC, US
    [job_card.full_time]
    Travel Radiology : MRI Tech Chapel Hill.Shift Details : 12H Days (12 : 00 AM-12 : 00 PM).Length : 13 WEEKS 13 weeks.Apply for specific facility details.[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Medical Director, North Carolina

    Medical Director, North Carolina

    Centene Corporation • Durham, NC, US
    [job_card.full_time] +1
    You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified, national organization offe...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Travel CT Tech - $1,855 to $2,132 per week in Chapel Hill, NC

    Travel CT Tech - $1,855 to $2,132 per week in Chapel Hill, NC

    Fusion Medical Staffing • Chapel Hill, NC, US
    [job_card.full_time]
    Facility in Chapel Hill, North Carolina.Fusion Medical Staffing is seeking a skilled CT Tech for a 13-week travel assignment in Chapel Hill, North Carolina. As a member of our team, you'll have the ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Travel MRI Tech - $1,935 per week in Chapel Hill, NC

    Travel MRI Tech - $1,935 per week in Chapel Hill, NC

    Atlas MedStaff • Chapel Hill, NC, US
    [job_card.full_time]
    Atlas Medstaff is currently seeking candidates in the MRI Tech (MRI Tech) profession for a 13 week contract in the Chapel Hill, North Carolina area. Atlas Medstaff is a premier staffing firm dedicat...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    FastMed - Roxboro, NC - NP / PA - Urgent Care

    FastMed - Roxboro, NC - NP / PA - Urgent Care

    Opportunity Healthcare • Roxboro, NC, United States
    [job_card.full_time]
    Specialty : Nurse Practitioner - Urgent Care, Physician Assistant - Acute Care, Physician Assistant - Urgent Care, Emergency Medicine - Urgent Care, Family Medicine - Urgent Care.PLEASE MAKE SURE TO...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]