CVHI Specialist (Contract & Compliance Manager)

California Veterans Health Initiative (CVHI) Specialist

The California Veterans Health Initiative (CVHI) Specialist reports directly to the National Mental Health Support Coordinator. This individual ensures compliance with established funding agreements while monitoring the fiscal operations of the CVHI grant including budgeting, financial reporting, and reconciliations. Key responsibilities include coordinating the managed care billing process, maintaining accurate financial records, and ensuring adherence to state, federal, and contractual policies. The CVHI Specialist also involves establishing and monitoring policies related to grant operations, risk management, and business continuity, as well as collaborating with staff on financial tracking and reporting. Additionally, the role directly supervises the Director of Clinical Services – CVHI (aka Clinical Director for the CVHI program), Intake Specialist, and will co-supervise the Outreach Specialist.

FLSA Classification: Exempt

• Ensures that the program maintains compliance with the established funding agreement with CalVet
• Monitors the fiscal operations of the grant (i.e., budgeting, accounts receivables and payables, reconciliations, financial reporting, etc.) to ensure monthly expenses are accurate
• Coordinates the managed care billing process, including managing local relationships with 3rd party insurance and ensuring that services provided comply with contractual and reimbursement policies
• Maintains and monitors all financial records to ensure accuracy, completeness of data, and compliance with state and federal rules and regulations
• Establishes and monitors policies and procedures pertaining to grant operations, risk management, and business continuity in the California Department of Veterans Affairs CVHI Notice of Funding Availability
• Ensures policies and procedures are aligned with current grant and any applicable accreditation standards
• Collaborates with staff around tracking financials, trends, and reporting, etc.
• Manages administrative staff to ensure all organizational standards are being followed
• Performs other duties as assigned

Requirements

• Bachelor’s degree from accredited college or university with at least 5 years of relevant experience
• At least 5 years of experience working with 3rd-party payers, coding, billing, posting, and adjudication of claims
• At least 3 years of experience collecting, analyzing, and reporting financial data
• Demonstrated knowledge about the appropriate and effective use of protected health information, the Health Insurance Portability and Accountability Act of 1996 and the Health Information Technology for Economic and Clinical Health Act
• Excellent customer service
• Must been able to work independently, as part of a team, anticipate problems, generate solutions, and demonstrate flexibility and sensitivity when engaging with staff and clients
• Excellent written and oral communication skills; ability to digest and distill complex subjects into clear messages
• Experience working with military populations and/or veterans is strongly preferred
• Valid driver’s license required and must be able to meet company insurance standards for drivers if applicable