Heritage Health Program Coordinator

Heritage Health Program Coordinator (Open)

If you are driven by excellence and are looking for a rewarding career opportunity, we invite you to apply for this position! The Department of Health and Human Services is seeking a motivated individual to join the Medicaid and Long-Term Care team to fill the role of Heritage Health Program Coordinator. The Heritage Health Program Coordinator will work under limited supervision, coordinate the administration of various state and federally funded programs throughout the state to include grant/contract administration, budget monitoring, and the development of program policies, procedures, and evaluation criteria to ensure compliance with state and federal regulations; perform related work as required. This position will monitor, analyze, and coordinate all grievance and appeal functions for one of the Heritage Health contracts. Heritage Health provides Medicaid covered physical health, behavioral health, dental health, and pharmacy services for Nebraska's Medicaid population. The program coordinator will be responsible for ensuring that their plan meets the operational requirements of the contract and complies with federal managed care rules and regulations, which are complex and extensive. "You have the passion; we have the opportunities – let's make a difference for Nebraskans!"

Job Duties

• Act as a liaison and confer with various federal and state authorities, health plan staff (including Director of Grievance and Appeals), policy review staff, care management staff, and community leaders.
• Review and prepare written oral summaries on state and federal legislation
• Provide analysis of Grievance and Appeals data and quality metrics.
• Coordinate the development of program goals and evaluation criteria with agency staff, health plans staff, community officials, and/or other state government staff.
• Participate in public hearings on proposed policy revisions.
• Develop corrective action plans for program deficiencies.
• Serve on relative community organizations, committees, task forces, and advisory boards.

Hire Rate: $26.138 per hour – non-exempt – Hire rate Increases July 1st to $26.726 per hour

Work Schedule: Monday – Friday; 8:00 AM -5:00 PM

Dress Attire: Business Casual

Location: Lincoln- Nebraska State Office Building

Driving is required

This position is in office only, no remote work.

Requirements / Qualifications:

Minimum Qualifications: Bachelor's degree in business or public administration, social/behavioral sciences, health sciences, public health, education, law or related field OR experience in the development of operational policies and procedures, performing quality assurance analysis/evaluation of programs; grant writing, contract management, or leading community based health/social care groups. Related coursework, training and/or education may substitute for the Bachelor's degree on a year-for year basis.

Preferred Qualifications:

• Experience in Medicaid and healthcare practice standards for either government or commercial plans.
• Experience and knowledge in program planning, implementation, monitoring, evaluating program functions.
• Advanced proficiency in Microsoft SharePoint, Excel, Outlook, Word, and PowerPoint.

Other: Valid driver's license or the ability to provide independent authorized transportation. Regular, predictable attendance is an essential job function.

Knowledge, Skills, and Abilities

Knowledge: Business and management principles. Quality assurance /performance improvement principles and methods of analyzing continuous improvement.

Skills: Communicate clearly and effectively orally or in writing.

Ability to: Relate well with a diverse number of individuals or organizations and work with people in a variety of roles (leadership, cooperation, education, and networking). Learn, apply, and interpret agency policies and procedures relating to areas of responsibility. Identify and relate pertinent pieces of information to form conclusions. Respond to changes in direction. Establish and maintain a positive working relationship with managers and administrators.