Administrator II – Medicaid Program Integrity and Provider Enrollment

State of Nebraska•Lincoln, NE

3d•Onsite

About The Position

The State of Nebraska, Department of Health and Human Services, Medicaid and Long-Term Care team is seeking a leader to direct the Program Integrity unit and the Provider Screening, Enrollment, and Revalidation unit. The role oversees two major units and multiple complex, diverse statewide programs that significantly affect agency operations. The Administrator II provides strategic leadership for Medicaid Program Integrity and Provider Screening business functions, contributes to departmental business and technical projects and agency-wide initiatives, and guides business-unit leaders in setting strategies, goals, and objectives aligned with agency objectives and federal and state regulations. The role partners with external stakeholders, including law enforcement agencies, the Federal Center for Medicaid and Medicare Services, the Attorney General’s office, department contractors, other state agencies, and providers and associations. The position is based at the Nebraska State Office Building in Lincoln. The stated starting hourly rate is $38.744, increasing to $40.682 after successful completion of original probation. The position is exempt.

Requirements

Bachelor’s degree in public administration, social work, human development, public health, behavioral science, law, finance, human resources, or another program-related field, plus four years of experience related to the assigned program area, including supervisory experience; OR a master’s degree in one of the listed fields and two years of commensurate experience.
Equivalent experience or coursework/training may be substituted for the education requirement on a year-for-year basis.
Valid driver’s license.
Knowledge of federal and state laws and regulations relevant to assigned programs.
Knowledge of quality assurance, performance improvement, and continuous improvement methods.
Knowledge of business and management principles, including strategic planning and resource allocation.
Knowledge of leadership, staff supervision, development, and coordination.
Knowledge of budget administration and fiscal management practices.
Skill in communicating information so others understand it.
Skill in using logic and reasoning to identify the strengths and weaknesses of alternative solutions.
Skill in identifying complex problems, developing and evaluating options, and implementing solutions.
Ability to interpret and apply agency policies, procedures, and changing priorities.
Ability to analyze complex organizational and operational issues, draw conclusions, and develop timely, cost-effective solutions.
Ability to establish program objectives, formulate policies, and evaluate progress toward goals.
Ability to conduct high-level analysis and coordinate interrelated activities across multiple departments.
Ability to exercise sound judgment, decisiveness, and creativity in critical or unexpected situations.
Ability to establish and maintain effective working relationships with executive leadership, community organizations, elected officials, and the public.
Ability to plan, assign, and supervise the work of others.
Ability to evaluate current departmental strategies and processes and identify new or innovative approaches to prevent or detect provider fraud, waste, and abuse.

Nice To Haves

Five years of direct experience leading teams responsible for preventing and investigating healthcare fraud, waste, and abuse.
Five years of direct experience leading teams responsible for screening healthcare providers to determine their appropriateness to provide healthcare services.
Direct experience implementing large, complex business and technical projects.
At least two years of experience leading at least two healthcare-related business functions simultaneously.

Responsibilities

Provide strategic leadership of Medicaid Program Integrity and Provider Screening business functions for the department.
Provide leadership and engagement in departmental business and technical projects and participate in department-wide initiatives and projects.
Oversee and guide business-unit leaders in setting strategy, goals, and objectives aligned with agency objectives and federal and state regulations.
Partner with external stakeholders, including law enforcement agencies, the Federal Center for Medicaid and Medicare Services, the Attorney General’s office, department contractors, other state agencies, and providers and associations.
Lead and direct the Program Integrity unit and the Provider Screening, Enrollment, and Revalidation unit.
Plan, assign, and supervise the work of others.
Evaluate current departmental strategies and processes and identify strategies to prevent or detect provider fraud, waste, and abuse.