Medicaid/Medicare Srvs Specialist III

Kentucky Personnel Cabinet • Frankfort, KY

2d • $47,531 - $71,298 • Hybrid

About The Position

The Department for Aging and Independent Living provides services for the aged and physically disabled populations across the state. The Department is charged with assisting individuals in obtaining needed home and community-based care and services to prevent premature admission into a long-term care facility. The goal of the departments programs is to assist individuals with remaining in their own home for as long as possible. The Department is currently seeking a high energy, self-motivated individual with the desire to assist the Division in supporting the departments goals.

Requirements

• Graduate of a college or university with a bachelor's degree.
• Four years of experience in Medicaid or Medicare program administration, health insurance administration/systems, eligibility systems, health care research, health care planning, health care financial management, health care policy development, human service or health care administration, insurance billing and/or claims, or research, review, and analysis of legislation or regulations.
• Experience in the above areas will substitute for the required college on a year-for-year basis.
• Current or prior military experience will substitute for the required college on a year-for-year basis.

Nice To Haves

• Excellent verbal and written communication skills.
• Excellent computer skills.
• Ability to plan and establish priorities, differentiating between urgent, important, and unimportant tasks.
• Excellent organization skills including time management, scheduling, coordinating resources and meeting deadlines.
• Attention to detail being thorough and accurate in completing tasks.
• Ability to work cooperatively as part of a team.
• Ability to work under pressure, being able to cope with a high volume of work and meeting deadlines.
• Exceptional customer service.
• Effective problem solver.
• Written and verbal communication skills.
• Works well in a fast-paced environment.
• Organization and time management skills.

Responsibilities

• Performs research and analysis of health care information for the Program of All Inclusive Care (PACE).
• Develops and maintains monitoring and data reports.
• Conducts monitoring of provider organizations to ensure compliance with standards of eligibility and program requirements according to state and federal regulations. Follows up on any corrective actions needed. Some statewide travel is required.
• Assists with the federal Centers for Medicare and Medicaid (CMS) audits.
• Responds to emails and phone calls, addressing questions related to PACE.
• Provides information and technical assistance to provider organizations.
• Makes recommendations for program policy and regulatory updates.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive