Special Enrollments Supervisor (PSA Opt 1)

State of Illinois • Springfield, MO

7d • Hybrid

About The Position

The Department of Healthcare and Family Services is seeking to hire a motivated candidate to serve as a Special Enrollments Manager assigned to the Bureau of Provider Enrollment Services. Under the direction of the Bureau Chief and Provider Enrollment Services Manager, this position plans, directs, and evaluates the Special Enrollments Unit for Sister Agencies and Managed Care Organizations. The ideal candidate will demonstrate excellent verbal and written communication skills, excellent leadership skills, ability to thrive in a high volume and fast paced environment, and demonstrate the ability to collaborate with internal and external entities to ensure enrollment procedures are followed. The preferred candidate should possess the ability to analyze data and work with internal and external entities to determine the best possible course of action for enrollment discrepancies. HFS values employees with different backgrounds, life experiences, and talents. Employees receive a robust benefit package including: Monday-Friday work schedule, flexible work schedules, and potential for remote work. At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained. HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer.

Requirements

• Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college.
• Requires prior experience equivalent to three (3) years of progressively responsible administrative experience in a public or business organization.
• Three (3) years of professional experience in provider enrollment, credentialing providers into a large medical health plan.
• Three (3) years of experience with applications such as Medicaid Management Information System (MMIS) databases, provider database, payee database or data warehouse database, including maintenance and upgrades.
• Minimum of three (3) years of experience interpreting Medicaid policies to ensure compliance with state and federal mandates and guidelines.
• Minimum of two (2) years of professional experience utilizing public or business administration, principles and practices.
• Minimum of two (2) years of experience supervising staff, providing employment motivation and development.
• Requires completion of a background check and self-disclosure of criminal history.
• Requires the ability to utilize and maintain state issued equipment such as a laptop.

Nice To Haves

• Three (3) years of professional experience in provider enrollment, credentialing providers into a large medical health plan.
• Three (3) years of experience with applications such as Medicaid Management Information System (MMIS) databases, provider database, payee database or data warehouse database, including maintenance and upgrades.

Responsibilities

• Serves as Special Enrollments Supervisor by planning, directing, and evaluating the Special Enrollments Unit for the Bureau.
• Serves as working supervisor.
• Develops, directs and reviews management studies that identify and implement new data elements for the Provider Database, as it relates to Section programs.
• Interprets Medicaid policies and the specifics of the section and other agency incentive programs to Department staff, officials, the medical community, and other agencies.
• Organizes, directs, and manages the establishment of Provider Database records for newly approved providers.
• Implements process to terminate or suspend providers that are convicted or found guilty of fraudulent Medicaid billing by the department’s Bureau of Medicaid Integrity, the U.S. Department of Health and Human Services, and/or the Department of Professional Regulations.
• Serves as backup to the Provider Enrollment Services unit supervisor.
• Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above.

Benefits

• Health, Life, Vision, and Dental Insurance
• Pension Plan
• Paid Parental Leave
• Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
• 12 paid Sick Days annually
• 10 paid Vacation Days their first year of service and can earn up to 25 paid Vacation Days annually
• 3 paid Personal Days annually
• (13-14) paid holidays annually (based on start date)

What This Job Offers

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