Statewide IL - Quality Specialist (Waiver Services Specialist)

Statewide IL - Quality Specialist (Waiver Services Specialist)

Hiring Department: Division of Specialized Care for Children

Location: Springfield, IL USA

Requisition ID: 1043509

FTE: 1

Work Schedule: Monday - Friday 8am - 4:30pm

Shift: Days

# of Positions: 1

Workplace Type: Hybrid

Salary Range (commensurate with experience): $50,000.00 - 65,000.00 / Annual Salary

About the University of Illinois Chicago

UIC is among the nation’s preeminent urban public research universities, a Carnegie RU/VH research institution, and the largest university in Chicago. UIC serves over 34,000 students, comprising one of the most diverse student bodies in the nation and is designated as a Minority Serving Institution (MSI), an Asian American and Native American Pacific Islander Serving Institution (AANAPSI) and a Hispanic Serving Institution (HSI). Through its 16 colleges, UIC produces nationally and internationally recognized multidisciplinary academic programs in concert with civic, corporate and community partners worldwide, including a full complement of health sciences colleges. By emphasizing cutting-edge and transformational research along with a commitment to the success of all students, UIC embodies the dynamic, vibrant and engaged urban university. Recent “Best Colleges” rankings published by U.S. News & World Report, found UIC climbed up in its rankings among top public schools in the nation and among all national universities. UIC has nearly 260,000 alumni, and is one of the largest employers in the city of Chicago.

This position is intended to be eligible for benefits. This includes Health, Dental, Vision, Life Insurance, a Retirement Plan, Paid time Off, and Tuition waivers for employees and dependents.

Position Summary
Responsible for reviewing, verifying, and coordinating all waiver service prior approval requests to ensure compliance with state and federal regulations. This position monitors incoming requests, reviews documentation for accuracy, and ensures that all required information and approvals are in place prior to submission to the Illinois Department of Healthcare and Family Services (HFS) for prior approval. The Waiver Services Specialist verifies vendor enrollment in IMPACT, maintains accurate provider information, and ensures that all submissions are person-centered while meeting established program and prior approval requirements.

In addition to processing requests, the Waiver Services Specialist provides technical assistance and guidance to Care Coordination Teams (CCTs), families, and waiver vendors, ensuring they understand waiver services requirements and processes. This position supports vendor onboarding and compliance, assists in training staff on waiver services, and compiles data for federal reporting. The Waiver Services Specialist plays a key role in identifying trends in service utilization, resolving issues, and supporting DSCC operations to promote timely, accurate, and compliant waiver services that keep participants safely supported in their communities.

Duties & Responsibilities

1. Review of Waiver Services Requests for proper authorization -- Conduct detailed reviews of waiver prior approval requests to ensure accuracy, completeness, and compliance with program requirements.

2. Monitor all waiver services requests and direct CCTs appropriately – Track and triage incoming requests, submissions, approvals and denials. Refer CCTs to the Financial Support/Waiver Support Center when requests require clarification or correction.

3. Review and ensure complete packet criteria for submission to HFS – Verify that all required documentation and approvals are included prior to submitting packets for prior approval.

4. Ensure vendors associated/approved for each request are IMPACT enrolled (Maintain Provider Grid) – Check provider enrollment status in IMPACT and update/maintain the Provider Grid to ensure accurate and compliant submissions.

5. Provide technical assistance to CCTs, Families, and Waiver Vendors on waiver service requests – Serve as a subject matter expert, answering questions and offering guidance to stakeholders throughout the approval process.

6. Provide vendor support during onboarding and issue resolution – Assist vendors with meeting compliance requirements, onboarding procedures, and resolving issues related to waiver service delivery.

7. Compile prior and post approval review data for federal and internal reporting – Collect and prepare data on waiver requests.

8. Monitor and prepare reports on waiver service utilization, patterns, and trends – Analyze data to identify trends in service usage and highlight potential areas for improvement.

9. Assist in training and educating CCTs on the waiver services prior approval process – Participate in staff training efforts and share knowledge to ensure consistent understanding of processes.

10. Support DSCC operations through other duties as assigned – Contribute to special projects and organizational initiatives as needed.

Minimum Qualifications

• Bachelor's degree as required by the position to be filled in the area of specialization inherent in the position may be required.
• One (1) year (12 months) of Quality Improvement work experience in a clinical or healthcare related field.

Preferred Qualifications

• Experience working with Medicaid Home and Community-Based Waiver services, including knowledge of prior approval processes and service coordination, to ensure participants remain safely supported in the community.
  
• Working knowledge of waiver service procedures, guidelines and request processes.
  
• Ability to review service requests for accuracy, completeness, and compliance with program requirements.
  
• Strong attention to detail and organizational skills.
  
• Ability to communicate effectively, both orally and in writing.

To Apply: For fullest consideration click on the Apply Now button, please fully complete all sections of the online application including adding your full work history with specific details of your duties & responsibilities for each position held. Fully complete the education, licensure, certification and language sections. You may upload a resume, cover letter, certifications, licensures, transcripts and diplomas within the application.

Please note that once you have submitted your application you will not be able to make any changes. In order to revise your application you must withdraw and reapply. You will not be able to reapply after the posting close date. Please ensure the application is fully completed and all supporting documents have been uploaded before the posting close date. Illinois Residency is required within 180 days of employment.

The University of Illinois System is an equal opportunity employer, including but not limited to disability and/or veteran status, and complies with all applicable state and federal employment mandates. Please visit Required Employment Notices and Posters to view our non-discrimination statement and find additional information about required background checks, sexual harassment/misconduct disclosures, and employment eligibility review through E-Verify.

The university provides accommodations to applicants and employees. Request an Accommodation

Artificial Intelligence (AI) tools may be used in some portions of the candidate review process for this position, however, all employment decisions will be made by a person.