Provider Enrollment Specialist (Public Service Representative 4) - 2 positions

State of Oregon•Street, MD

5d•Hybrid

About The Position

If this opportunity aligns with your strengths, background, and commitment to fostering inclusivity, we encourage you to apply! At the Oregon Health Authority (OHA), we value diversity and encourage applicants from all backgrounds and experiences to help us build a stronger, more equitable future for all. Opportunity Awaits, Apply Today! – Provider Enrollment Specialist (Public Service Representative 4) This posting will be used to fill two (2) permanent, full-time positions. These positions are classified and are represented by a union. Provider Enrollment Specialist (2 positions): The purpose of this position is to process provider Medicaid Program applications using internal and external data and documents submitted by providers to ensure complete and accurate information has been received and enrolled by assisting the providers with enrollment and program requirements. This role will validate providers have not been excluded with the goal of verifying that the information submitted by providers meets with the required Federal and State minimum qualifications. This position will compare submitted data (and researched external data) with Federal and State regulations for quality and metric measures to determine if providers qualify to participate in the Medicaid Program. This specialist will communicate with providers the outcome of the review and reason for denial of enrollment if applicable. In alignment with OHA's values and strategic goal to eliminate health inequities in Oregon by 2030, the person in this role will demonstrate ongoing development of personal cultural awareness and humility, and knowledge of social determinants of health and their impacts on health outcomes. Click Here to view a Dashboard of all current recruitments for the Medicaid Division. On the dashboard, you will see a link to the full position description for the position(s) associated with this REQ-194354.

Requirements

Three years of experience performing public contact and/or customer service duties comparable to the work of a Public Service Representative.
At least two years of this experience must include dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance.

Nice To Haves

Demonstrated experience providing advanced, person-centered customer service while engaging diverse individuals and organizations, informed by cultural awareness, humility, and knowledge of social determinants of health.
Demonstrated experience building and maintaining constructive, collaborative working relationships to support implementation of policies, projects, and programs that promote equity, inclusion, and incorporation of lived experience.
Demonstrated experience explaining, interpreting, and applying laws, rules, and policies through clear verbal communication and well-documented written materials.
Demonstrated experience researching, reviewing, and applying federal and state regulations, including Medicaid requirements, to support daily decision-making and determine appropriate outcomes.
Demonstrated experience accurately entering, validating, and maintaining complex healthcare or enrollment data while meeting productivity and quality expectations.
Demonstrated experience synthesizing information from multiple sources, analyzing data, and preparing reports using advanced tools such as Microsoft Excel, Word, Outlook, and collaboration platforms including Microsoft Teams and SharePoint to support program operations, compliance, and continuous improvement.
Demonstrated experience providing training, technical assistance, or subject-matter support related to policies, procedures, systems, or program requirements.
Demonstrated ability to independently plan, prioritize, and manage workload in a fast-paced environment with shifting priorities.

Responsibilities

Process provider Medicaid Program applications using internal and external data and documents submitted by providers to ensure complete and accurate information has been received and enrolled by assisting the providers with enrollment and program requirements.
Validate providers have not been excluded with the goal of verifying that the information submitted by providers meets with the required Federal and State minimum qualifications.
Compare submitted data (and researched external data) with Federal and State regulations for quality and metric measures to determine if providers qualify to participate in the Medicaid Program.
Communicate with providers the outcome of the review and reason for denial of enrollment if applicable.
Demonstrate ongoing development of personal cultural awareness and humility, and knowledge of social determinants of health and their impacts on health outcomes.

Benefits

Excellent, low-cost medical, vision, and dental coverage for you and your family.
Optional benefits like life insurance, disability coverage, deferred compensation, and FSA options for health and childcare.
Generous paid time off: 11 holidays, 3 personal days, monthly sick leave, and vacation accrual starting at 8 hours/month.
Potential eligibility for the Public Service Loan Forgiveness Program.
Retirement security through Public Employees Retirement System (PERS)/Oregon Public Service Retirement Plan (OPSRP).
Training and development opportunities to grow your career with the State of Oregon.

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