Medicaid Program Specialist 3

at  State of Alaska

THIS POSITION IS OPEN TO ALASKA RESIDENTS ONLY.

Please check our residency definition to determine if you qualify.
The Department of Health, Division of Behavioral Health, is recruiting for a Medicaid Program Specialist 3 position in our Anchorage office.

WHO WE ARE LOOKING FOR:

• Accountability: Hold self and others accountable for measurable, high-quality, timely, and cost-effective results. Determines objectives, sets priorities, and delegates work. Accepts responsibility for own actions and decisions.
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  Compliance: Knowledge of procedures for assessing, evaluating, and monitoring programs or projects for compliance with Federal/State laws, regulations, and guidelines.
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  Program Oversight: Plans, coordinates, and monitors programs to ensure that Federal, State, and/or local government program requirements and plans are met, providing professional consultation on the specialized services of the program or associated projects.
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  Quality Assurance: Knowledge of the principles, methods, and tools of quality assurance and quality control used to ensure a product fulfills functional requirements and standards.
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  Analysis and Assessment: Uses information technology in accessing, collecting, analyzing, maintaining, and disseminating data and information.
  A cover letter is NOT required for this position. Your complete application, including supplemental questions, will be used to determine which applicants will advance to the interview phase of the recruitment and selection process.
  To view the general description and example of duties for this job class, please go to the following link and search for Medicaid Program Specialist 3: https://www.governmentjobs.com/careers/Alaska/classspecs.

ANY COMBINATION OF EDUCATION AND/OR EXPERIENCE THAT PROVIDES THE APPLICANT WITH COMPETENCIES IN:

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  Analytical Thinking/Problem Solving: Uses a logical, systematic, and sequential approach to address problems or opportunities or manage a situation by drawing on one’s knowledge and experience base and calling on other references and resources, as necessary.
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  Oral Communication: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately.
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  Technical Expertise: Effectively applies technical knowledge to solve a range of problems; develops technical solutions to new or highly complex problems that cannot be solved using existing methods or approaches; is sought out as an expert to provide advice or solutions in the technical area.
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  Written Communication: Writes in a clear, concise, organized, and convincing manner for the intended audience.
  equivalent to those typically gained by:
  Progressively responsible professional experience such as supporting the administration of a Medicaid or Medicare program, health insurance service, health insurance management information system, health insurance finance or accounting program, Supplemental Security Income benefits or vocational rehabilitation program; auditing or monitoring medical or public assistance programs for fraud or quality assurance; processing medical claims using medical coding and medical billing knowledge; designing, developing, testing for quality assurance, and implementing an information system and/or training or education which includes such course work as business administration, computer sciences, economics, healthcare, legal studies, medical billing or coding, public health, public assistance, psychology.

EDUCATION

To verify education is being used to meet and/or support the required minimum qualifications/competencies, you must fill in the Education section of the application. If you have not obtained a degree, please indicate the number of units completed. Copies of transcripts are required to verify educational credentials used to meet or support the minimum qualifications/competencies for a position and are required with each application. (Unofficial is okay; please ensure the institution/URL name is listed on the transcripts). Transcripts can be attached at the time of application or provided at the time of interview; if not, transcripts will be required before employment.

WORK EXPERIENCE

When using work experience not already documented in your application, please provide the employer’s name, your job title, employment dates, and whether you were working full-time or part-time. Applications will be reviewed to determine if the responses are supported and if minimum qualifications are met. Work experience needed to meet the minimum qualifications must be documented in the application. If the application does not support minimum qualifications, the applicant may not advance to the interview and selection phase of the recruitment. A resume will not be used to determine that minimum qualifications have been met for the position to which you are applying.
If you have currently or previously been appointed to a flexibly staffed position, please ensure your work experience within a flexibly staffed position indicates the actual dates employed at each level. Ensure your time and any subsequent flex promotion(s) are documented as a separate position. This is required as minimum qualifications require experience at a particular level in which the lower level may not be considered. If this information is not accurately reflected in your application, this may cause the processing of your application for consideration to be delayed.
NOTE: Attaching a resume or curriculum vitae is not an alternative to filling out the application. Noting “see resume or CV” or any similar response on any portion of your application may lead to a determination your application is incomplete and removal from consideration for this job posting.
The State of Alaska does not provide VISA Employer sponsorships.

Under the supervision of the Medicaid Program Specialist 4, the successful candidate will provide critical oversight of Medicaid program activities as they relate to behavioral health, including providing statewide oversight of Medicaid claims and coding activities to prevent Medicaid Fraud, Waste, and Abuse.
The Medicaid Program Specialist 3 analyzes claims data as submitted by Alaska Medicaid Providers, verifying the data is accurate and compliant with Federal and State regulations. The candidate researches information related to licensing, federal and state sanctions, reviews claims, compiles overpayment spreadsheets, provides technical assistance, and delivers crucial reports that ensures the Division of Behavioral Health meets the requirements of Federal and State regulations, including its Legislative Audits.