Medicaid Program Specialist 1

Job Posting

This position is exempt from the hiring freeze. Qualified applicants are encouraged to apply. Welcome to the Department of Health. We'd be delighted to have you join our team. If you envision yourself in this role and are ready to start an exciting career with us, apply today. 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 role, you will take the lead in requesting and managing service authorizations for approved Medicaid Waiver/State Plan and Personal Care Services programs. You will work directly with service provider agencies and multiple state entities to navigate and coordinate day-to-day authorization needs. Your work will include processing service authorization requests in the designated MMIS system, while ensuring every action aligns with relevant policies and state and federal regulatory requirements.

Mission and Values/Culture: The mission of SDS is to promote health, well-being, 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.

Benefits of Joining Our Team: The Quality Assurance Unit is a multi-faceted environment, where we strive to create a balance between hard work, compassion, collaboration, and fun. By joining our team, you will work alongside a group of professionals committed to the well-being and safety of seniors and individuals who experience a disability, while ensuring their continued access to quality services in the setting of their choosing.

The Working Environment You Can Expect: The office is located in Anchorage, Alaska, at 1835 Bragaw Street, Suite 350. This location is convenient to numerous shops, restaurants, and trails. Telework is possible in this position upon successful completion of a probationary period and approval from the Division Director. This position is scheduled for a 7.5-hour workday with flexible hours between 8 and 5:30 pm.

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.
• Computer Skills: Uses computers, software applications, databases, and automated systems to accomplish work.
• Customer Service: Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement.

Minimum Qualifications: 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 intended only as parameters and guidelines. A competency's description is not intended to exclusively define every KSA, task, and behavior needed to meet the competency successfully, but rather to provide the manager/agency with a broad reference of options as to how an applicant can meet the job expectation.

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:

"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, online, self-study, and on-the-job), from accredited and unaccredited sources, and long-duration programs (such as a post-secondary degree) and short-duration programs (such as a seminar).

"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 with current daytime telephone numbers, two (2) of which must be of current or former supervisors, if not already provided in the application.
2. Two (2) of your most recent job performance evaluations. If they are not available, then provide two (2) letters of recommendation from previous supervisors.
3. 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 qualification competencies, if not already provided in the application.

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 level of competence in applying certain behaviors, knowledge, skills, and abilities to accomplish a specific task. The four proficiency levels are Mastery, Fluency, Literacy, and Discovery.

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 documented in your application, please provide the employer's name, job title, employment dates, and whether you worked 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 the minimum qualifications have been met for the position you are applying for. 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.

Multiple Vacancies This recruitment may be used for more than one (1) vacancy. The applicant pool acquired during this