Medicaid Consulting Services

The Vendor is required to provide to enhance our medicaid financing strategies and billing practices.
- Provide a comprehensive engagement focused on policy development, project management, and stakeholder collaboration to maximize revenue from reimbursable medicaid services, ultimately strengthening our community's vital health and human services.
- Maximize county's medicaid revenue for reimbursable services;
- Improve current medicaid billing practices across county departments;
- Develop and implement compliant medicaid policies and operational procedures; and
- Explore partnership opportunities with service providers to expand reimbursable services. - Responsible for providing expert guidance and hands-on support to county in optimizing its medicaid financing strategies and billing practices (for non-FQHC related services).
- This will involve a multi-faceted approach encompassing policy development, project management, and comprehensive stakeholder engagement, with the ultimate goal of maximizing revenue from reimbursable Medicaid services.
- Policy Development and Regulatory Expertise:
•    In-depth research and interpretation: conduct comprehensive research and interpretation of federal, state, and local laws, regulations, and policies relevant to medicaid, chip, long term care, human services, behavioral health, housing navigation, health related social services and other publicly financed health programs to inform and guide county medicaid policy.
•    Best practice integration: research and interpret national best practices for medicaid billing and reimbursement to inform policy and operational procedure development.
•    Policy and procedure drafting: draft clear, actionable, and compliant policies and operational procedures aimed at maximizing revenue from medicaid reimbursement, translating complex regulations into practical guidance for county departments.
•    New and emerging practices: provide knowledge and guidance on new and emerging practices, including but not limited to community care hubs, value based care, risk based payments, and fee for service vs capitated rate.
- Project Management and Implementation Planning:
•    Billing practice improvement plan: develop a detailed implementation plan to significantly improve current medicaid billing practices across all relevant county departments. 
•    This plan should include specific steps, timelines, and measurable outcomes.
•    Strategic collaboration: facilitate and lead collaborative efforts across various county teams and external contracted service agencies to advance and integrate medicaid financing strategies.
•    Opportunity and risk assessment: identify and analyze potential opportunities and associated risks with expanded medicaid finance and billing strategies, providing recommendations for mitigation and optimization.
•    Comprehensive documentation: prepare thorough reports, detailed recommendations, comprehensive budgets, robust implementation plans, and all necessary policy documentation.
- Stakeholder Engagement and Communication:
•    Collaborative policy development: engage actively with internal county teams and external stakeholders to collaboratively develop effective and compliant medicaid policies and procedures.
•    Knowledge transfer and training: develop and deliver clear and concise explanations of medicaid policy and procedures through various mediums, including memos, bulletins, and educational materials, ensuring county staff are well-informed and able to implement new practices effectively.
•    Public and internal presentations: prepare and deliver presentations, and participate in public hearings and policy discussions as required, to articulate Medicaid strategies and policies.

- Contract Period/Term: 1 year