Level of Care Evaluation Unit (LOCEU) Program Review Analyst

State of Oklahoma • OK

90d • $55,970

About The Position

The Level of Care Evaluation Unit (LOCEU) Program Review Analyst plays an essential role in supporting the Oklahoma Health Care Authority by serving as a medical eligibility and audit analyst. This position will independently determine medical eligibility for the OHS TANF Incapacity, Aid to the Disabled, Medical Assistance, Aid to the Blind, Alien Emergency Services, TEFRA, and DDS programs. The LOCEU Program Analyst will be responsible for designing, producing, and analyzing complex database reports using various software tools, consulting with internal divisions and external stakeholders, and supporting the agency’s mission to deliver better health outcomes for Oklahomans. They will facilitate communication and correspondence between the LOCEU unit, OHCA, and multi-agency programs. In a marginal role the LOCEU Program Analyst will cross train to support the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 program and the Program of All-inclusive Care for the Elderly (PACE). The role also involves overseeing reporting activities, evaluating program measures, and identifying operational issues, contributing to the agency’s strategic goals through data-driven insight to ensure compliance with federal and state regulations.

Requirements

• Bachelor’s degree and 1 year of professional or technical administrative experience in business or public administration OR an equivalent combination of education and experience, substituting 1 year of qualifying experience for each year of the required education.
• Technical administrative experience would include highly complex clerical work gained under the direct supervision of a professional supervisor or manager.

Nice To Haves

• Experience with assessing program eligibility or determining and applying appropriate LOC criterion for MAGI HAP population, the TEFRA Medicaid program, PACE Program, and Home and Community-Medicaid Waivers recipients.
• Advanced education.
• Knowledge of federal and state rules and regulations pertaining to Medicaid eligibility; medical terminology, injuries, diseases, human anatomy, psychological/physiological factors.
• Experience working with Medicaid-funded programs, Long-Term Services and Supports (LTSS), Long-Term Care, or Aged, Blind, and Disabled (ABD) initiatives.
• Strong customer service or case management background, ideally in a health or human services agency.

Responsibilities

• Independently determine medical eligibility for the DHS TANF Incapacity, Aid to the disabled, Medical Assistance and Aid to the Blind, Alien Emergency Services, TEFRA, and DDS recipients’ programs.
• Consult with interagency divisions and external organizations to drive program objectives and recommend standards for monitoring and evaluating program measures.
• Serve on teams and workgroups to facilitate new or innovative thinking and perform related tasks as assigned.
• Create and maintain various unit computer reports/files/charts/graphs/data.
• Compile statistics on the OHS Advantage Waiver program as federally mandated.
• Properly identify & resolve inquiries and unit issues.
• Take initiative to problem solve issues found in the unit, communicate with supervisor, and suggest solutions and/or assist when a unit need arises.
• Utilize OHCA/OHS network programs like IMS/ICE/CCM/PASRR as well as OHCA/OHS Medicaid policy and procedure.
• Facilitate communication among LOCEU Unit, OHCA, and multi-agency programs as required.
• Prepare analysis of data and the presentation of that data collected.
• Consistently support OHCA mission vision, and goals through engagement in learning and demonstration of OHCA competencies, code of ethics, core values, and adherence to policies and procedures.

Benefits

• Generous state-paid benefit allowance to offset insurance premiums.
• A wide selection of top-tier health insurance plans.
• Optional flexible spending accounts for health care or dependent care expenses.
• Employee Assistance Program (EAP) offering confidential support.
• Wellness benefits, including an on-site gym and fitness center discounts.
• 11 paid holidays annually.
• 15 vacation days and 15 sick days in your first year.
• Retirement Savings Plan with substantial employer contributions.
• Longevity Bonus to reward years of service.
• Public Service Loan Forgiveness eligibility and reimbursement for educational expenses.
• Professional development training opportunities, including CEU support.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Bachelor's degree