Program Integrity Projects Manager

State of Nebraska•Lincoln, NE

1d•Onsite

About The Position

The State of Nebraska, Department of Health and Human Services, Medicaid and Long-Term Care team is seeking a highly motivated leader to join their team as the Program Integrity Projects Manager. The essential purpose of the position is the oversight and day-to-day work associated with ensuring that significant Program Integrity projects are successfully completed. Under limited supervision, responsible for the management and oversight of a single program with limited scope or multifaceted functions of a program within the Department of Health and Human Services. Performs activities necessary to plan, organize, direct and evaluate the activities of an assigned program with limited scope or multiple program function(s) through the supervision of subordinate program staff; manages resources necessary to operate and maintain assigned program function(s); develops and/or revises the assigned program/functions operating policies, procedures and objectives within agency and/or regulatory guidelines; coordinates program/function services with other State, local and federal agencies, health professionals and service agencies; performs related work as assigned. “You have the passion; we have the opportunities – let’s make a difference for Nebraskans!”

Requirements

Bachelor’s degree in business or public administration, social/behavioral sciences, education, health sciences, public health, law or related field and experience in program planning, implementation, monitoring, evaluating program functions or supervising/management staff and budgets.
Related coursework, training and/or education may substitute for the Bachelor’s degree on a year-for-year basis.
Valid driver's license or the ability to provide independent authorized transportation.
Knowledge of the principles and techniques of management; business and management principles including planning, budgeting, resource allocation and human resources; the principles of grant writing and grant administration; the techniques of research, planning and evaluation; work performance or other standards of development; program analysis/evaluation; policy development.
Skill in communicating to convey information so others will understand; drafting procedures; writing documentation or content.
Ability to plan, assign, direct and evaluate the work of subordinate staff; learn, apply and interpret agency policies and procedures relating to the assigned program or function; learn, apply and interpret State and federal laws and standards; develop and maintain effective relationships with program representatives and the public; apply instructions; summarize program and administrative data/statistics into reports; formulate goals and plans; manage time and workflow of oneself and that of others to meet deadlines; demonstrate professionalism; operate basic computer software and hardware.

Nice To Haves

Knowledge of Nebraska Medicaid covered services and regulations (471, 482, & 482).
Experience with provider fraud, waste, or abuse investigations, managing projects that involve Department staff and internal and external parties.
Experience with Department systems including NFOCUS, MMIS, HIA, and Monday.com
Experience with investigations into compliance with regulations.

Responsibilities

Manage several Program Integrity projects – The Payment Error Rate Measurement Audit
Provide collaboration with the Managed Care Entities and the Unified Program Integrity Contractor and implementation and management of requirements related to 68-974.
Program Integrity Activity Reporting Development, design, implementation, and training related to new changes and projects or audits.
Manage several Program Integrity Investigators