Medicaid Eligibility Specialist

Job Description Welcome to the Department of Health! We’d be delighted to have you join our team. This position is open to Alaskan Residents only. Please check out the residency definition to determine if you qualify. What you will be doing: As the Medicaid Program Associate, you will play an important role in supporting the Medicaid Program Integrity and protecting Medicaid resources. You will assist audit and review staff by researching provider and claims information, reviewing and organizing supporting documentation, maintaining accurate case records, and tracking audit and review activities. You will communicate with providers, contractors, and Department staff to obtain information and support timely follow-up on identified concerns. Your attention to detail and ability to organize and manage information will help the Medicaid Program Integrity team ensure identified issues are properly documented, followed up on, and resolved while supporting the Department’s efforts to prevent and address fraud, waste, and abuse within the Medicaid program. Our organization, mission, and culture: The Department of Health, Medicaid Program Integrity is a small team whose mission is to preserve and protect the integrity of the Medicaid program by proactively developing strategies to identify, deter, and prevent fraud, waste and abuse. The benefits of joining our team: This position offers an opportunity to work with a team of professionals dedicated to safeguarding the integrity of the Medicaid program by proactively developing strategies to prevent fraud, waste and abuse. Our team encourages continual learning, including training opportunities through the Medicaid Integrity Institute (MII) hosted by Centers for Medicare and Medicaid Services (CMS), the National Association for Medicaid Program Integrity (NAMPI), and the National Health Care Anti-Fraud Association (NHCAA). Team members currently enjoy a hybrid work schedule that includes time in the office and time teleworking, and it encourages a collaborative and supportive work environment. The working environment you can expect: This position is in the Frontier Building in midtown Anchorage, a secure office space with free parking. We offer a professional office environment with daily collaboration among dedicated colleagues and offer a hybrid work schedule. Who we are looking for: The ideal candidate will possess some or all of the following position-specific competencies in addition to the minimum qualifications listed below: Attention to Detail: Is thorough when performing work and conscientious about attending to detail. Manages and Organized Information : Identifies a need; gathers, organizes, and maintains information; determines its importance and accuracy, and communicates it by a variety of methods. Technical Credibility : Understands and appropriately applies principles, procedures, requirements, regulations, and policies related to specialized expertise. To view the general description and example of duties for this job class, please go to the following link and search for Medicaid Program Associate : classspecs Minimum Qualifications Competency-Based Minimum Qualifications Instructions This job class uses competency-based minimum qualifications. Please ensure your application (through work history, volunteer experience (duties summary), training, education, licenses, certifications, etc.) supports how you have gained the knowledge, skills, abilities, and behaviors (competencies) and that you possess the minimum required competencies for the job class. Competency Description The competency description(s) listed below have been designed to promote a common understanding of the essential elements of the job class. They highlight the more general and customary knowledge, skills, abilities (KSAs), tasks, and behaviors used to describe the competency. They typically list expectations rather than specific tasks and are to be used only as parameters and guidelines. A competency’s description is not intended to exclusively define every KSA, task, and behavior needed to successfully meet the competency, but rather to provide the manager/agency with a broad reference of options as to how an applicant can meet the job expectation. Please ensure your application (through work history, training, education, licenses, certifications, etc.) supports/demonstrates that you possess the minimum required competencies for the job class. Any combination of education and/or experience that provides the applicant with competencies in Customer Service: Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement. 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 applying program requirements and working with individuals in stressful situations 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. “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, are required. One (1) of these references 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 is okay; please ensure that the institution name/URL is listed on the transcripts) is used to support that you meet the minimum qualifications competencies. Please read the information below carefully. This applies to your application submission. SUPPLEMENTAL QUESTIONS For your application to be evaluated, you must answer the Supplemental Questions. The State of Alaska uses four proficiency levels to measure and describe an applicant's competence in applying specific behaviors, knowledge, skills, and abilities to accomplish a specific task. The four proficiency levels are Mastery, Fluency, Literacy, and Discovery. You must rate your proficiency level for each competency listed in the supplemental questions. 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 #J-18808-Ljbffr