Medicaid Program Specialist 3 (PCN 064053)

State of Alaska
Anchorage, AK Full Time
POSTED ON 5/10/2024 CLOSED ON 5/31/2024

What are the responsibilities and job description for the Medicaid Program Specialist 3 (PCN 064053) position at State of Alaska?

Job Description

This position is open to Alaskan Residents only.
Please check out the residency definition to determine if you qualify.

What you will be doing:
In this position, you would be a Medicaid policy and program expert who coordinates complex Medicaid programs and provides significant analysis and research to draft policies in accordance with State and Federal laws and regulations.  You would be responsible for the management of program fee schedules; ensuring appropriate processing of claims; Management of policies, guidance, and publications; Providing program guidance and information to stakeholders, providers, and members; program audits; fiscal reporting; and program monitoring for areas of risk and needed change as well as drafting recommendations for effective management of Medicaid activities that may commit the State to a significant course of action.

You would also coordinate and implement the Physician, Advance Nurse Practitioner/Nurse Midwife, Physician Assistant, Certified Registered Nurse Anesthetist, Direct Entry Midwife, Psychologist, Imaging, and Laboratory programs.

Our organization, mission, and culture:
Our mission is to provide health coverage to Alaskans in need and maintain the operations aspects of health care programs for Alaskans in need. We provide a full range of healthcare services and support services while ensuring management efficiencies and capitalizing Medicaid financing to ensure that services are available to customers.

We are charged to protect and reduce the risk to the health, safety, and exploitation of Alaska's most vulnerable citizens being served and to ensure that there is public confidence in the health care and community service delivery systems through regulatory, enforcement, and educational activities.
 
The benefits of joining our team:
We are a dynamic, innovative, and fast-paced team. All team members' input is valued, and we are always looking to provide growth and learning opportunities for our team members.

This position includes a generous benefits package that covers health insurance, retirement, 11 paid holidays, paid time off accrual, and the potential for annual pay raises based on performance.
 
The working environment you can expect:
The current work environment involves two days in the office for team interaction and three days teleworking from home. Onsite workdays are located at 4601 Business Park Blvd, Bldg. K in Anchorage, which is central for shopping, restaurants, and commuting. Free parking is also available.
 
Who we are looking for:
  • Customer Service: Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement. 
  • Attention to Detail: Is thorough when performing work and conscientious about attending to detail.
  • Analysis and AssessmentUses information technology in accessing, collecting, analyzing, maintaining, and disseminating data and information.
  • Computer Skills: Uses computers, software applications, databases, and automated systems to accomplish work.
Special Notice:
  • Knowledge of Medicaid/Medical Assistance terminology, programs, policies and procedures, and rules and regulations at the state and federal levels preferred.
  • Sufficient knowledge of health care services, claims, and delivery systems is preferred.

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.

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. 
  • 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. 
  • 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.

 

Special Note:

“Competencies” means a combination of interrelated knowledge, skills, abilities, and behaviors that enable a person to act effectively in a job or situation.

 

“Professional experience” means work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the power or right to decide or act according to one's own judgment.  

 

“Progressively responsible” means indicating growth and/or advancement in complexity, difficulty, or level of responsibility.

“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 the time of the interview, please provide the following: 

  1. 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.  
  2. A copy of your last three (3) performance evaluations or two (2) letters of reference if evaluations are unavailable.

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, 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.

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:
http://doa.alaska.gov/dop/workplace/help/
 
NOTICE
Questions regarding the application process can be directed to the Workplace Alaska hotline at 800-587-0430 (toll-free) or (907) 465- 4095. 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 'govermentjobs.com' domains.  For information on allowing emails from the 'governmentjobs.com' domains, visit the Lost Password Help page at
https://www.governmentjobs.com/OnlineApplication/User/ResetPassword.
 
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 1-800-587-4095 in Juneau or TTY: Alaska Relay 711 or 1-800-770-8973 or correspond with the Division of Personnel & Labor Relations at P. O. Box 110201, Juneau, AK 99811-0201. 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 1-800-587-0430 (toll-free) or (907) 465-4095 if you are in the Juneau area. Requests for information may also be emailed to
recruitment.services@alaska.gov.
 
For applicant password assistance, please visit https://www.governmentjobs.com/OnlineApplication/User/ResetPassword.                

Contact Information

For specific information in reference to the position, feel free to contact the hiring manager at:
 
Karen Benson/Medicaid Program Specialist 4
Email: Karen.Benson@alaska.gov
Housing Program Specialist II (Anchorage)
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Petersburg Medical Center -
Petersburg, AK
Environmental Program Specialist 3 (PCN 187563)
State of Alaska -
Multiple Locations, AK

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