Medicaid Program Specialist 1 (PCN 062381)
About The Position
This Individual Position is Exempt from the Hiring Freeze. Qualified Applicants are Encouraged to Apply. Welcome to the Department of Health. We’d be delighted to have you join our team. If you envision yourself in this role and are ready to start an exciting career with us, apply today. This Position Is Open To Alaskan Residents Only. Please check out the residency definition to determine if you qualify. In this role, you will take the lead in requesting and managing service authorizations for approved Medicaid Waiver/State Plan and Personal Care Services programs. You will work directly with service provider agencies and multiple state entities to navigate and coordinate day-to-day authorization needs. Your work will include processing service authorization requests in the designated MMIS system, while ensuring every action aligns with relevant policies and state and federal regulatory requirements.
Requirements
- Competencies in Analytical Thinking/Problem Solving: Uses a logical, systematic, and sequential approach to address problems or opportunities or manage a situation by drawing on one’s knowledge and experience base and calling on other references and resources, as necessary.
- Competencies in Oral Communication: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately.
- Competencies in Written Communication: Writes in a clear, concise, organized, and convincing manner for the intended audience.
- Experience supporting the administration of a Medicaid or Medicare program, health insurance service, health insurance management information system, health insurance finance or accounting program, Supplemental Security Income benefits or vocational rehabilitation program.
- Experience auditing or monitoring medical or public assistance programs for fraud or quality assurance.
- Experience processing medical claims using medical coding and medical billing knowledge.
- Training or education which includes course work such as business administration, computer sciences, economics, healthcare, legal studies, medical billing or coding, public health, public assistance, psychology.
Nice To Haves
- Attention to Detail: Is thorough when performing work and conscientious about attending to detail.
- Computer Skills: Uses computers, software applications, databases, and automated systems to accomplish work.
- Customer Service: Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement.
Responsibilities
- Requesting and managing service authorizations for approved Medicaid Waiver/State Plan and Personal Care Services programs.
- Working directly with service provider agencies and multiple state entities to navigate and coordinate day-to-day authorization needs.
- Processing service authorization requests in the designated MMIS system.
- Ensuring every action aligns with relevant policies and state and federal regulatory requirements.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
