Medicaid Program Specialist 1 - Anchorage, United States - State of Alaska

Description

Medicaid Program Specialist 1 (PCN | Government Jobs page has loaded.
Medicaid Program Specialist 1 (PCN

This position is open to Alaska Residents only.
Please check our

residency definition

to determine if you qualify .
This position is open to Alaska Residents only.
Please check our

residency definition

to determine if you qualify .


What you will be doing:

The Medicaid Program Specialist I, Certification Reviewer position serves a key role in the certification process of current and prospective Medicaid Home and Community Based Services (HCBS) providers.

As a member of the Provider Certification and Compliance Unit, this position is primarily responsible for reviewing and evaluating applications in accordance with applicable standards for HCBS providers (waiver and personal care services) who apply to obtain or maintain certification to participate with Medicaid.

The incumbent reviews and analyzes provider documentation and issues determinations on certification applications, tracks and trends issues with providers, and makes recommendations for quality improvement activities.

In addition, the successful candidate for this position serves a vital technical assistance role for providers as well as processes changes in provider statuses during certification periods.

Collaboration with appropriate partner agencies and referrals for inappropriate service provisions and/or non-compliance are also included in the duties of this position.

Our organization, mission, and culture:

Senior and Disabilities Services promotes health, wellbeing and safety for individuals with disabilities, seniors and vulnerable adults by facilitating access to quality services and supports that foster independence, personal choice and dignity.

The benefits of joining our team:

You will work with a talented, dedicated and professional team who are driven to ensure quality services are provided to Alaska's most vulnerable citizens so they can thrive in their home communities.

Working within a team of nine staff and in close collaboration with other teams at SDS, as well as other partner agencies.

There is ample opportunity to have a positive impact on the lives of Alaskans as well as gain valuable professional experience in the field of Medicaid compliance, certification and quality assurance.

The working environment you can expect:
This position is located in East Anchorage next to East High School. We are currently working in a hybrid teleworking model. This position is primarily office-based; however, some local travel may be required.

The Anchorage office is located at:

1831 Bragaw Street. Anchorage, Alaska


Who we are looking for:
Any combination of education and/or experience that provides the applicant with the following competencies in:


Adaptability/Flexibility:
Is open to change and new information and effectively deals with uncertainty.

Adjusts planned work by gathering relevant information and applying critical thinking to address multiple demands and competing priorities in a changing environment.

Adapts behavior or work methods in response to new information, changing conditions, or unexpected obstacles.


Interpersonal Skills:

Shows understanding, friendliness, courtesy, tact, empathy, concern, and politeness to others; develops and maintains effective relationships with others; may include effectively dealing with individuals who are difficult, hostile, or distressed; relates well to people from varied backgrounds and different situations; is sensitive to cultural diversity, race, gender, disabilities, and other individual differences.

Organizational Awareness:

Knows the organization's mission and functions, and how its social, political, and technological systems work and operates effectively within them; this includes the programs, policies, procedures, rules, and regulations of the organization.

Self-Management:

Sets well-defined and realistic personal goals; displays a high level of initiative, effort, and commitment towards completing assignments in a timely manner; works with minimal supervision; is motivated to achieve; demonstrates responsible behavior.

Writing:

Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a succinct and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.

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 a Medicaid Program Specialist 1, please go to the following link:

classspecs

Job Description

This position is open to Alaska Residents only.
Please check our

residency definition

to determine if you qualify .


What you will be doing:

The Medicaid Program Specialist I, Certification Reviewer position serves a key role in the certification process of current and prospective Medicaid Home and Community Based Services (HCBS) providers.

As a member of the Provider Certification and Compliance Unit, this position is primarily responsible for reviewing and evaluating applications in accordance with applicable standards for HCBS providers (waiver and personal care services) who apply to obtain or maintain certification to participate with Medicaid.

The incumbent reviews and analyzes provider documentation and issues determinations on certification applications, tracks and trends issues with providers, and makes recommendations for quality improvement activities.

In addition, the successful candidate for this position serves a vital technical assistance role for providers as well as processes changes in provider statuses during certification periods.

Collaboration with appropriate partner agencies and referrals for inappropriate service provisions and/or non-compliance are also included in the duties of this position.

Our organization, mission, and culture:

Senior and Disabilities Services promotes health, wellbeing and safety for individuals with disabilities, seniors and vulnerable adults by facilitating access to quality services and supports that foster independence, personal choice and dignity.

The benefits of joining our team:

You will work with a talented, dedicated and professional team who are driven to ensure quality services are provided to Alaska's most vulnerable citizens so they can thrive in their home communities.

Working within a team of nine staff and in close collaboration with other teams at SDS, as well as other partner agencies.

There is ample opportunity to have a positive impact on the lives of Alaskans as well as gain valuable professional experience in the field of Medicaid compliance, certification and quality assurance.

The working environment you can expect:
This position is located in East Anchorage next to East High School. We are currently working in a hybrid teleworking model. This position is primarily office-based; however, some local travel may be required.

The Anchorage office is located at:

1831 Bragaw Street. Anchorage, Alaska


Who we are looking for:
Any combination of education and/or experience that provides the applicant with the following competencies in:


Adaptability/Flexibility:
Is open to change and new information and effectively deals with uncertainty.

Adjusts planned work by gathering relevant information and applying critical thinking to address multiple demands and competing priorities in a changing environment.

Adapts behavior or work methods in response to new information, changing conditions, or unexpected obstacles.


Interpersonal Skills:

Shows understanding, friendliness, courtesy, tact, empathy, concern, and politeness to others; develops and maintains effective relationships with others; may include effectively dealing with individuals who are difficult, hostile, or distressed; relates well to people from varied backgrounds and different situations; is sensitive to cultural diversity, race, gender, disabilities, and other individual differences.

Organizational Awareness:

Knows the organization's mission and functions, and how its social, political, and technological systems work and operates effectively within them; this includes the programs, policies, procedures, rules, and regulations of the organization.

Self-Management:

Sets well-defined and realistic personal goals; displays a high level of initiative, effort, and commitment towards completing assignments in a timely manner; works with minimal supervision; is motivated to achieve; demonstrates responsible behavior.

Writing:

Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a succinct and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.

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 a Medicaid Program Specialist 1, please go to the following link:

classspecs
Minimum Qualifications

Any combination of education and/or experience that provides the applicant with competencies in:

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.

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.

Written Communication:
Writes in a clear, concise, organized, and convincing manner for the intended audience.

equivalent to those typically gained by:

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 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.

Special Note:
Requires infrequent local and in-state travel via automobile to conduct provider onsite reviews.

"Competencies" means a combination of interrelated knowledge, skills, abilities, and behaviors that enable a person to act effectively in a job or situation.
"Training" and "education" in this guidance are synonyms for the process of acquiring knowledge and skills through instruction. It includes instruction through formal and informal methods (such as classroom, on-line, self-study, and on-the-job), from accredited and unaccredited sources, and long-duration (such as a post-secondary degree) and short-duration (such as a seminar) programs.
"Typically gained by" means the prevalent, usual method of gaining the competencies expected for entry into the job.
Additional Required Information

At time of interview applicant(s) are requested to submit:

Three (3) professional references whom we may contact by phone, one (1) of whom must be your current or most recent supervisor, if not already provided in the application.

Current performance evaluation, if available.

A copy of academic transcripts (unofficial are okay; please ensure that the institution name/URL is listed on the transcripts) is used to support that you meet the minimum qualification competencies.

Please read the below information carefully. This applies to your application submission.


SUPPLEMENTAL QUESTIONS
For your application to be evaluated, you must answer the Supplemental Questions. Be specific in your answers and describe how you acquired the relevant experience. Please use complete sentences and proofread your submissions when answering the supplemental questions.

Your responses will be considered a writing sample and used to determine which applicants will advance to the interview phase of the recruitment process.

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.

SPECIAL INSTRUCTIONS FOR FOREIGN
EDUCATION

If education is completed in a foreign college or university, it may be used to meet the above requirements, if applicable.

If utilizing this education, you must show that the education credentials have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and that such education has been deemed to be at least equivalent to that gained in conventional U.S.

education programs or an accredited U.S.

state university reports the other institution as one whose transcript is given full value, or full value is given in subject areas applicable to the curricula at the state university.

It is your responsibility to provide such evidence when applying.

The omission of the required documentation listed will result in an incomplete application, and you will not receive further consideration.

WORK EXPERIENCE

When using work experience not already documented in your application, please provide the employer's name, your job title, dates of employment, and whether full-or part-time.

Applications will be reviewed to determine if the responses are supported, and minimum qualifications are clearly 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 in 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.


RECRUITMENT SCOPE
This position is open to Alaska Residents only. Please check ou r

residency definition

to determine if you qualify.


MULTIPLE VACANCIES
This recruitment may be used for more than one (1) vacancy.

The applicant pool acquired during this recruitment may be used for future vacancies for up to ninety (90) days after this recruitment closes.

Interested applicants are encouraged to apply to each recruitment notice to ensure consideration for all vacancies.


APPLICATION
NOTICE
You can ONLY apply for this position through the Workplace Alaska website or via hardcopy application.

If you accessed this recruitment bulletin through a job search portal such as AlaskaJobs or any other database, you MUST use a Workplace Alaska online or hardcopy application to apply successfully.

Instructions on how to apply with Workplace Alaska may be found on the Workplace Alaska "How to Apply" webpage, found here:


NOTICE
Questions regarding the application process can be directed to the Workplace Alaska hotline at toll-free) or

If you choose to be contacted by email,

please ensure your email address is correct on your application and that the spam filter will permit email from the '' domains.

For information on allowing emails from the '' domains, visit the Lost Password Help page at

.


EEO STATEMENT
The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA).

Individuals with disabilities who require accommodation, auxiliary aides or services, or alternative communication formats, please call in Juneau or TTY:
Alaska Relay 711 or or correspond with the Division of Personnel & Labor Relations at P. O. Box 110201, Juneau, AK The State of Alaska is an equal opportunity employer.

WORKPLACE ALASKA APPLICATION QUESTIONS & ASSISTANCE
Questions regarding application submission or system operation errors should be directed to the Workplace Alaska hotline at toll-free) or if you are in the Juneau area. Requests for information may also be emailed to

.

For applicant password assistance please visit:

Contact Information

For specific information in reference to the position, feel free to contact the hiring manager at:


Name:
Kristen Bearden, Health Program Manager 2


Phone:

Email:
Agency

State of Alaska

Phone

Statewide toll-free number)
Juneau and out-of-state callers)

Website

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