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24 Hour Home Care · 23 hours ago

EPSDT/Compliance Administrator (Albuquerque, NM)

Albuquerque, New Mexico, United States

Full-time

Onsite

Mid Level

$21/hr - $22/hr

Inteli-Care LLC is a non-medical home health care provider based out of Albuquerque, New Mexico. The EPSDT/Compliance Administrator is responsible for the administration, compliance oversight, and coordination of EPSDT Personal Care Services in accordance with New Mexico Medicaid requirements.

Health CareHome Health Care

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; Associate's or bachelor's degree in healthcare administration or related field preferred

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

Strong knowledge of compliance, audits, and healthcare operations

Proficiency in MS Office (Word, Excel, PowerPoint) and other relevant software

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

Must be able to talk, listen, and speak clearly on the telephone

While performing the duties of the job, employee is required to stand, walk, stoop, bend, sit for long periods of time; and must be able to read, write, speak, and hear well enough to communicate

Manual dexterity is required to utilize keyboards and office equipment

Employee may occasionally be required to lift up to 20lbs to file documents, and/or store office material

Push and pull 50 pounds (move equipment, etc.)

Carry equipment/supplies

Use upper body strength

Squeeze with hands (operate fire extinguisher)

Twist

Bend

Stoop/squat

Move quickly (respond to emergencies)

Climb stairs

Walk