Medicaid/Medicare Srvs Specialist III
About The Position
The Department for Aging and Independent Living provides services to older adults and people with physical disabilities across Kentucky. It helps individuals obtain needed home- and community-based care and services to prevent premature admission to long-term care facilities and supports people in remaining in their homes as long as possible. The Department is seeking a high-energy, self-motivated individual to support the Division and the Department’s goals. The role performs advanced analysis of records to identify provider deficiencies; evaluates regulations and policies and recommends improvements; develops, interprets, and maintains statistical reports and tracking spreadsheets; responds to complex inquiries; and analyzes and reports the effects of policy changes to inform decisions and strategic planning. It also conducts monitoring and technical reviews of agencies that provide waiver services. The position is based at 275 E Main Street, Frankfort, Kentucky. The agency may authorize telecommuting and may modify or end that arrangement at any time. Incumbents primarily work in an office setting. The role is full-time, 37.5 hours per week, and eligible for overtime pay. The initial and promotional probationary period is six months, except as provided in KRS 18A.111.
Requirements
- A bachelor's degree from a college or university, or qualifying experience in the specified areas substituting for the degree on a year-for-year basis. Current or prior military experience also substitutes for the college requirement on a year-for-year basis.
- Four years of experience in Medicaid or Medicare program administration; health insurance administration or systems; eligibility systems; health care research, planning, financial management, policy development, or administration; insurance billing or claims; or research, review, and analysis of legislation or regulations.
- Excellent verbal and written communication skills.
- Excellent computer skills.
- Ability to plan and establish priorities, distinguishing urgent, important, and unimportant tasks.
- Strong organization, time-management, scheduling, and coordination skills, including the ability to meet 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.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
