EPSDT/Compliance Administrator (Albuquerque, NM) jobs in United States
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24 Hour Home Care · 1 day ago

EPSDT/Compliance Administrator (Albuquerque, NM)

Inteli-Care LLC is a non-medical home health care provider based in Albuquerque, New Mexico, focused on delivering high-quality service with a member-first approach. The EPSDT/Compliance Administrator will oversee compliance and administration of EPSDT Personal Care Services, ensuring adherence to New Mexico Medicaid requirements and managing various operational responsibilities.

Health CareHome Health Care
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Culture & Values

Responsibilities

Manage EPSDT referral intake, tracking, and service initiation
Coordinate new member onboarding, ensuring eligibility verification, service authorizations, and required RN assessments
Schedule and maintain RN supervisory and reassessment visits per NM EPSDT timelines
Maintain accurate EPSDT member records in compliance with MAD and DOH standards
Compliance Program Management
Develop and maintain compliance policies, procedures, and work instructions aligned with NM Medicaid regulations
Ensure compliance with DOH, HCA/MAD, and federal Medicaid requirements
Conduct internal compliance audits and maintain audit readiness
Regulatory Knowledge & Monitoring
Interpret NM Administrative Code (NMAC) and Turquoise Care EPSDT policies
Monitor regulatory updates and implement required operational changes
Staffing, Supervision & Workforce Management
Onboard Personal Care Assistants (PCAs)
Maintain PCA schedules to meet authorized service plans
Conduct PCA trainings, evaluations, and competency validations
Validate timesheets/mileage and maintain personnel records for EPSDT PRN RN’s
Ensure timely renewals and compliance for all employees
Auditing, Investigations & Incident Management
Receive, document, and investigate all incidents
Conduct internal investigations and corrective action plans
Report findings to the VPO and CEO
Training & Education
Educate staff on EPSDT policies, compliance, and NM regulatory requirements
Maintain documentation of all required trainings
Recordkeeping & Reporting
Maintain accurate compliance, personnel, and EPSDT records
Produce internal and external reports as required
Marketing & Communications
Assist with marketing initiatives and community outreach

Qualification

NM Medicaid/EPSDT experienceCompliance knowledgeHealthcare operations knowledgeMS Office proficiencyEMR/LMS software experienceMultitasking abilityCurrent CPR certificationBilingual (English/Spanish)Communication skillsOrganizational skills

Required

High school diploma or equivalent
Proficiency in MS Office (Word, Excel, PowerPoint) and other relevant software
Strong knowledge of compliance, audits, and healthcare operations
Strong communication skills, both written and verbal
Excellent organizational skills and attention to detail
Ability to multitask and prioritize tasks effectively
A friendly disposition and ability to work well with diverse groups of people
Current CPR certification is required for this position and must be maintained throughout employment in accordance with agency policy, New Mexico Healthcare Authority (HCA), and Medicaid/EPSDT requirements

Preferred

Associate's or bachelor's degree in healthcare administration or related field
Experience with NM Medicaid/EPSDT or PCS services
EMR/LMS software experience
Bilingual (English/Spanish)

Company

24 Hour Home Care

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One of the largest, most trusted in-home care companies in the nation.

Funding

Current Stage
Late Stage
Total Funding
unknown
2021-10-14Acquired

Leadership Team

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Ryan Iwamoto
President and Co-Founder
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Jacqueline E. Davis ✯ COO, CPA
Chief Financial Officer, CFO | Chief Operations Officer, COO | Vice President, VP | Controller
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