CMA Quality Improvement and Billing Supervisor

Compensation Range

$80,142.40 - $108,180.80

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Job Description Summary

This position leads a Case Management Agency team with responsibility for quality assurance, staff training, and oversight of purchasing and billing functions. Supervises and develops staff to ensure quality standards are met and that purchasing, billing, and documentation practices remain accurate, compliant, and aligned with audit and regulatory standards.

Work location will primarily be in the Greeley Office, however, may travel to meeting locations throughout the state and attend national conferences.
Reliable, predictable attendance within department business hours of 8 a.m. to 5 p.m. Monday through Friday. Work may involve time away from a standard office environment. Work may occur in various community settings that are potentially hazardous and may require additional precautions, such as personal protective equipment and/or requesting assistance from emergency medical personnel or law enforcement. After hours and on call work situations may occur on occasion to provide support to families that need services outside of normal business hours. This position is in-person with a possibility for limited telework opportunities when needed.

Ideal candidate traits:
1. Demonstrates sound, independent judgment.
2. The ability to make and clearly communicate defensible approval decisions based on program requirements, supporting documentation, and fiscal control.
3. Collaborates and communicates effectively across all organizational levels.
4. Experience with Long-Term Services and Supports
5. High attention to detail and accuracy in processing financial transactions and documentation

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Job Description

Supervision & Leadership - 30%

• Directly supervise the daily activities of the staff responsible for training, quality assurance, program reimbursement and payment operations.
• Monitor staff participation in program related meetings, trainings, and conferences to ensure alignment with best practices and agency expectations.
• Create an environment that fosters a high level of employee engagement within the division by ensuring staff are provided adequate resources, clear expectations, and frequent communication.
• Encourages integrity and excellence in case management, models and expects the case management agency team to be open and flexible to new and different approaches and responsibilities.
• Ensures their team maintains current knowledge of applicable rules, regulations, and state requirements and represents the agency appropriately at required meetings and committees.
• Provides coaching and assistance as needed to help staff attain and hone required skills and knowledge.
• Addresses employee concerns and resolves problems in collaboration with department administration and County Human Resources.

Quality Assurance & Training Oversight - 20%

• Oversee the auditing, case review, and quality monitoring activities conducted by the specialists to ensure accuracy, compliance, and timeliness of case management functions.
• Review, track, and respond to documented case audit findings, ensuring follow up and continuous quality improvement across the team.
• Ensure random re-reviews of quality outcomes are performed for accuracy and compliance with established standards.
• Ensure the specialists provide timely, actionable feedback to staff and serves as a knowledgeable technical resource.
• Oversee the specialist’s role in modeling high-quality, person centered practices and ensuring consistent standards across the team.
• Monitor both the internal case review process as well as all other quality reviews that are required to be completed through State quality assurance requirements.

Billing, Purchasing, & Reimbursement Oversight - 20%

• Oversees all CMA billing, reimbursement, and contract related compliance activities, ensuring accurate payments, reconciliation, and timely submission of deliverables.
• Conduct supervisory review for all CMA purchases before routing for final approval.
• Monitor CMA program activities with fiscal implications to ensure they meet regulatory requirements for reimbursement, and ensuring that all billing, purchasing, and supporting documentation aligns with compliance standards and positions the agency to successfully pass audits.
• Provide oversight into the CMAs purchasing and billing operations to ensure maximum revenue through accurate documentation and compliant practices.
• Ensures staff maintain accurate tracking and reporting of contract performance measures, reimbursement data, provider fee schedule updates, and required documentation.
• Provide leadership direction for data tracking systems related to billing, utilization, wait lists, financial information, and reporting, ensuring data integrity and alignment with program and contract requirements.
• Ensure proper administrative controls for document processing, quality checks, and validation of financial and billing related materials.

Collaboration & Staff Development - 15%

• Direct and approve the development, implementation, and delivery of onboarding and ongoing training curricula for CMA staff.
• Ensure training materials, tools, manuals, and presentations remain updated with regulatory and procedural changes.
• Use training and quality feedback to identify staff performance trends, skill gaps, and areas requiring additional development.
• Develop and monitor performance of the quality assurance team to efficiently and effectively ensure case reviews and case analysis are complete, data analysis/evaluation is provided to leadership, and to identify trend analysis.
• Partner with CMA leadership to develop, refine, and implement internal policies and procedures that improve program effectiveness and compliance.

Professionalism & Teamwork - 10%

• Balances team and individual responsibilities; puts success of team above own interests.
• Exhibits objectivity and openness to others’ views; gives and welcomes feedback.
• Treats others with respect and consideration regardless of their status or position
• Contributes to building a positive work culture.
• Accepts responsibility for own actions and follows through on commitments.

Policies & Procedures - 5%

• Follow policies and procedures, the Weld County Code of Conduct and adhere to strict confidentiality guidelines and appropriate release of information outlined in both.
• Any one position may not include all duties listed, nor do the listed examples include all duties which may be found in positions of this class.

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Required Qualifications

Required Education

• Bachelor's Degree or 5 years experience in the field of Long-Term Services and Supports (LTSS), which includes Developmental Disabilities or
• A combination of education and relevant experience appropriate to the requirements of the position. Relevant experience is defined as: (a) Experience in one of the following areas: long-term care services and supports, gerontology, physical rehabilitation, disability services, children with special health care needs, behavioral science, special education, public health or non-profit administration, or health/medical services, including working directly with persons with physical, intellectual, or developmental disabilities, mental illness, or other vulnerable populations as appropriate to the position being filled; AND (b) Completed coursework and/or experience related to the type of administrative duties performed by case managers may qualify for up to two (2) years of required relevant experience.

Experience Qualifications

• 1 year of competency in pertinent case management knowledge and skills. This is defined as Long-Term Services and Supports Case Management or the performance of similar duties and responsibilities in a directly related human services or public assistance field.
• Experience working with aging and disability populations.
• Experience working collaboratively with community partners.

Preferred Experience

• Experience with Colorado Case Management Agency Long-Term Services and Supports waiver programs and/or State General Funds Programs
• Experience supervising and managing employees that includes directing work activities and evaluating employee performance
• Experience in data and compliance management
• Experience presenting and developing training modules

Licenses and Certifications

• Candidate must pass Human Services Background Checks (Required)
• Candidate must pass a Colorado Adult Protective Services (CAPS) check and will continue to be monitored by CAPS throughout employment. (Required)
• Driving is essential in this position.
• Candidate must have a valid Driver’s License and Liability Insurance (Upon Hire Required)
• Candidate must pass a Motor Vehicle Record (MVR) evaluation and if hired, will be subject to continuous monthly MVR monitoring throughout employment. Candidate must provide own transportation and be willing to travel and transport clients as needed to meet the essential functions of the position. (Required)
• Pre-employment substance screening is required for this position.
• This position is subject to a pre-employment drug screening. Employment is contingent upon successfully passing the screening in accordance with Weld County policy.

This position is exempt from the minimum wage and overtime requirements of the Fair Labor Standards Act and is therefore ineligible for overtime pay.

As an applicant for this position, you should be aware of Senate Bill 19-085, the Equal Pay for Equal Work Act. The act requires employers to announce the pay range for job openings.

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Use the link below to get a closer look at the generous benefits offered:

https://www.weld.gov/Government/County-Information/Join-Our-Team/Employee-Benefits

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Weld County is an equal employment opportunity employer. We ensure that all employment practices are conducted without regard to race, color, religion, sex, national origin, age, disability status, marital status, sexual orientation, gender identity or expression, genetic information, protected veteran status or any other protected status in accordance with federal, state, and local laws. Weld County pledges to uphold a work environment free from discrimination and harassment, promoting fairness and dignity for all employees. We actively take affirmative action to comply with nondiscrimination policies and invite qualified individuals in need of reasonable accommodations to contact our Human Resources Department at [email protected] or (970) 400-4234.