Medicaid Program Specialist 3 (PCN 065342)
Job Posting for Medicaid Program Specialist 3 (PCN 065342) at State of Alaska
Job Description
- 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.
What You Will Be Doing:
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.
Our Organization, Mission, and Culture:
The mission of the Division of Behavioral Health is to manage an integrated and comprehensive behavioral health system based on sound policy, effective practices, and partnerships.
Our Values: Honesty, Dignity, Innovation, Diversity, Collaboration
The benefits of joining our team:
We offer challenging and exciting work that has a positive impact on the lives of Alaskans. The Division is guided by our belief that every employee is a change agent, and ideas, individual values and beliefs are respected as they enrich our overall team environment.
This position is being filled in Anchorage. DOPLR is offering flexible in-office and telework arrangements for State of Alaska personnel.
The working environment you can expect:
Anchorage Office: Conveniently located in Midtown Anchorage and within walking distance to Cuddy Family Park, Loussac Library, and Natural Pantry.
This position is office-based work in a dynamic environment.
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.
- Compliance: Knowledge of procedures for assessing, evaluating, and monitoring programs or projects for compliance with Federal/State laws, regulations, and guidelines.
- 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.
- 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.
- 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. 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:
- Three (3) professional references whom we may contact by phone, one (2) of whom must be your current or most recent supervisor, if not already provided in the application.
- Copies of your two most recent performance evaluations, if available.
- A copy of academic transcripts, (unofficial are okay, please ensure that the institution name/URL is listed on the transcripts); to verify that you meet the minimum qualifications.
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.
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.
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: 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:
Ryan J. Knight-Cole, Administrative Assistant 2
Phone: (907) 269-3614
Fax: (907) 269-3623
Email: ryan.knight@alaska.gov
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Salary.com Estimation for Medicaid Program Specialist 3 (PCN 065342) in Anchorage, AK
$106,662 to $131,234
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