Medicaid/Medicare Srvs Specialist III

Kentucky Personnel Cabinet • Frankfort, KY

8d • $48,483 - $71,298

About The Position

The Department for Aging and Independent Living provides services for older adults and people with physical disabilities throughout Kentucky. It helps individuals obtain home- and community-based care and services to prevent premature admission to long-term care facilities and support people in remaining in their homes as long as possible. The department is seeking a high-energy, self-motivated individual to support these goals. The role performs advanced analysis, policy and regulatory evaluation, reporting, complex inquiry response, and monitoring and technical reviews of agencies providing waiver services. Duties are primarily performed in an office setting. The agency may authorize telecommuting and may modify or end that arrangement at any time.

Requirements

• Bachelor's degree from an accredited college or university, or qualifying experience in the listed fields substituted year-for-year for the college requirement.
• Four years of experience in Medicaid or Medicare program administration, health insurance administration or 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 or claims, or research, review, and analysis of legislation or regulations.
• Experience in the listed areas or current or prior military experience may substitute for the required college education on a year-for-year basis.
• Excellent verbal and written communication skills.
• Excellent computer skills.
• Ability to plan and prioritize tasks, including distinguishing urgent, important, and unimportant work.
• Strong organization and time-management skills, including scheduling, coordinating resources, and meeting deadlines.
• Attention to detail and accuracy.
• Ability to work cooperatively as part of a team.
• Ability to work under pressure, manage a high volume of work, and meet deadlines.
• Exceptional customer service skills.
• Effective problem-solving skills.
• Ability to work well in a fast-paced environment.

Responsibilities

• Perform advanced analysis of records to identify provider deficiencies.
• Evaluate regulations and policies and provide expert recommendations for improvement.
• Develop, interpret, and maintain comprehensive statistical reports and tracking spreadsheets.
• Address complex inquiries and prepare detailed oral or written responses.
• Analyze and report the impact of policy changes, providing expert insight to inform decision-making and strategic planning.
• Conduct monitoring and technical reviews of agencies providing waiver services.

What This Job Offers

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