Medicaid Program Integrity - Helena, United States - State of Montana

State of Montana Helena, United States

3 weeks ago

Description

Medicaid Program Integrity (MPI) Compliance Specialist

The Montana Department of Public Health and Human Services (DPHHS) is offering a career opportunity within the Office of Inspector General/Program Compliance Bureau.
This role involves identifying and investigating potential provider fraud, abuse, and waste in Montana Medicaid and Healthy Montana Kids (HMK) programs.
Why Join DPHHS
At DPHHS, our mission is to serve Montanans in their communities, improve and protect health, safety, and well-being, and promote independence. Joining our department means contributing to meaningful public service for our state and its residents.
The State of Montana provides a comprehensive benefits package, including healthcare coverage, retirement plans, paid vacation, sick leave, and holidays. Employees also enjoy work/life balance and eligibility for the Public Service Loan Forgiveness (PSLF) program. DPHHS offers a variety of advancement opportunities, catering to both new entrants and experienced professionals.
Qualifications for this Career Opportunity
Knowledge of Medicaid rules, medical claims processing, terminology, and coding principles.
Familiarity with the Health Information Portability and Accountability Act (HIPPA) compliance.
Proficiency in reviewing, investigation, and research.
Effective presentation skills for small groups.
Aptitude for math calculations.
Analytical and critical thinking abilities.
Skills in operating a personal computer and general office equipment for essential functions, including using spreadsheets, word processing, databases, email, and internet.
Minimum qualifications include:
Bachelor's degree in health sciences, health information, accounting, business, or social sciences.
Two years of experience in medical claims, coding, or service review.
Other relevant combinations of education and experience will be assessed on a case-by-case basis.
Preferred coding certification through the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC).

General Vocational Rehabilitation Services Bureau Chief

2 weeks ago

State of Montana Helena, United States

General Vocational Rehabilitation Services Bureau Chief The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Disability Employment and Transitions Division (DETD), General Vocational Rehabilitation Bureau. · Do you love working ...
Software Engineer, Senior

1 week ago

State of Montana Helena, United States

Software Engineer, Senior OLIS is engaged in a few major projects. The first initiative replaces all the solutions that support the automation of Montana's legislative process. The second converges many different technical solutions into the same technical stack. The third reduc ...
Database Administrator/Analyst

2 days ago

State of Montana Helena, United States

Description: · The Montana Public Employee Retirement Administration (MPERA) agency is committed to providing secure and sustainable retirement benefits to nearly 60,000 members and retirees.The agency administers nine defined benefit retirement plans and is dedicated to custome ...
Federal Grants Coordinator

1 week ago

State of Montana Helena, United States

Job Overview: · This position exercises leadership, technical assistance and general supervision within the Title I/Federal Grants Unit through interaction with the local education agencies (LEAs); local, state, national, and federal organizations; institutions; agencies; and po ...
Information Governance Unit Business Analyst 1

3 weeks ago

State of Montana Helena, United States

Job Overview: · This position resides in the of the . The Information Management Bureau is responsible for processing paper and electronic payments, returns, and correspondence, managing customer information, and handling software vendor relations. Our employee values are a cent ...
Health and Fitness Manager

2 weeks ago

Touchmark at Wedgewood Helena, United States

Health and Fitness Manager · Helena, MT, USA Req # Tuesday, May 7, ETHIC – Excellence, Teamwork, Hospitality, Integrity, and Compassion – steadfastly characterizes our mission to continually enrich the daily lives of residents. We practice these principles with every task and ...
Service Now Developer

1 day ago

State of Montana Helena, United States

Job Overview: · This position is primarily responsible for the development and delivery of ServiceNow platform solutions for DNRC.Responsibilities will include: · Development, modification, and delivery of software solutions (primarily in the ServiceNow platform, but may vary by ...
Cost Analyst

3 weeks ago

State of Montana Helena, United States

Cost Analyst Join Our Team as a Cost Analyst and Make a Difference in Environmental Protection. · The Petroleum Tank Release Compensation Board (PTRCB) is seeking a dedicated and experienced Cost Analysis Specialist to play a crucial role in overseeing program compliance and ens ...
Senior HR Generalist

1 week ago

State of Montana Helena, United States

Senior HR Generalist Why live in Helena, Montana? · Helena is surrounded by rolling hills and lofty mountains and is tucked below the Continental Divide. · It is a relatively quiet place to call home where small-town living collides with outdoor adventure. · Helena has a rich ...
Reliability Engineer

1 week ago

Troy Corporation Helena-West Helena, United States

Overview · Arxada is a pioneering leader with a powerful legacy: Over 120 years of creating specialty chemicals and solutions that potentiate the performance of our customers and their products. Our solutions, our expertise and our support help them to perform better - to be m ...
Equipment Operator

1 week ago

CRH Helena, United States

Job ID: 498274 · Helena Sand & Gravel, a CRH company, is a member of the CRH West Division; Our purpose, commitment to the future, and formula for growth is to champion the safety, empowerment, and development of our employees. We strive to be the preferred source of quality sand ...
Research Operations Analyst

1 week ago

State of Montana Helena, United States

MISSION STATEMENT · : Empowering all Montanans through work and opportunity. · DLI CORE VALUES: · Responsiveness · Respect · Integrity · Excellence · Cohesiveness · It's about the people and the impact we make in our communities every day. We are proud of our open, team-based, ...
Massage Therapy Program Psychology Instructor, Helena College

2 weeks ago

The University of Montana Helena, United States Part time

Helena College University of Montana, a comprehensive two-year college focused on student success, seeks qualified applicants for a Psychology Instructor for the Massage Therapy Certificate Program . · Under the supervision of the Director of the Massage Therapy Program, this par ...
IT Supervisor: Application/Software Development

17 minutes ago

State of Montana Helena, United States

IT Supervisor: Application/Software Development Expand your career and make a difference by joining the team at Montana DEQ and help us champion a healthy environment for a thriving Montana · We are seeking an Application/Software Development Supervisor within the Information Te ...
Contract Manager

3 weeks ago

State of Montana Helena, United States

Contract Manager CONTRACT MANAGER · REHAB AND PROGRAMS · HELENA, MT · MISSION - Montana Department of Corrections is creating a safer Montana through Accountability, Rehabilitation and Empowerment. · If you want to work making positive changes in the community the Montana De ...
IT Project Management Specialist

1 week ago

State of Montana Helena, United States

IT Project Management Specialist (Release Train Engineer Do you have a passion for building relationships, solving highly complex problems, and driving technological change to increase value for the State of Montana? Then, consider joining our team to support the Information Tec ...
Family Engagement Meeting Coordinator

2 weeks ago

State of Montana Helena, United States

Family Engagement Meeting Coordinator The Montana Department of Public Health and Human Services (DPHHS) has a career opportunity within the Child and Family Services Division. · Child and Family Services provides family-centered services within a trauma-informed system to ass ...
Workforce Consultant

1 week ago

State of Montana Helena, United States

MISSION STATEMENT · : Empowering all Montanans through work and opportunity. · DLI CORE VALUES: · Responsiveness · Respect · Integrity · Excellence · Cohesiveness · It's about the people and the impact we make in our communities every day. We are proud of our open, team-based, ...
Privacy Analyst

2 weeks ago

State of Montana Helena, United States

MISSION STATEMENT · : Empowering all Montanans through work and opportunity. · DLI CORE VALUES: · Responsiveness · Respect · Integrity · Excellence · Cohesiveness · It's about the people and the impact we make in our communities every day. We are proud of our open, team-based, ...
Memory Care Administrator

4 weeks ago

Touchmark at Wedgewood Helena, United States

Memory Care Administrator · Helena, MT, USA Req # Friday, May 17, ETHIC – Excellence, Teamwork, Hospitality, Integrity, and Compassion – steadfastly characterizes our mission to continually enrich the daily lives of residents. We practice these principles with every task and ...