This position is open to Alaska Residents only.
Please check our residency definition to determine if you qualify.
The Department of Health Care and Social Services,
Division of Health Care Services is currently looking for a
Medicaid Program Specialist III for the Systems Unit.
What you will be doing:
This position serves as benefit plan administrator and institutional claims lead, contract management and quality assurance analyst in the Division of Health Care Services Systems and Analysis Unit. Responsibilities includes maintenance for the Clinical Laboratory Improvement Amendments (CLIA) interface, national code sets, and diagnosis and surgical codes. Additional responsibilities will include testing and quality assurance evaluation of claims processing and reporting systems, to ensure processing systems fulfill State and Federal requirements for Medicaid administration and reporting, particularly in the areas of health care provider billing and payment.
Our Organization, Mission and Culture:
The mission of the Division is to provide all eligible Alaskans access to quality Medicaid services. The vision of the Division is to improve quality of health care for all Alaskans, attract excellent providers and provide outstanding customer service. The contributions of the selected candidate ensure that the goals and visions of the Division are being met by ensuring the integrity of the system is maintained and conforms to the federal and state rules and regulations.
The Benefits of Joining Our Team:
We are a dynamic, innovative, and fast-paced team. All team members input is valued, and we are always looking to provide growth and learning opportunities for our team members.
The Work Enviornment:
Currently this position is on telework status.
Who we are looking for:
To be successful in this position a candidate will need the following core competencies:
Problem Solving: Identifies problems; determines accuracy and relevance of information; uses sound judgment to generate and evaluate alternatives, and to make recommendations. Experience in conducting detailed, comprehensive and technically-oriented reviews of system testing documents, audit trails, system outputs, related reports and documents.
Reasoning: Identifies rules, principles, or relationships that explain facts, data, or other information; analyzes information and makes correct inferences or draws accurate conclusions. Experience and skills that demonstrate an ability to independently analyze and apply comprehensive business rules, regulations, policies, and health payer industry standards as they apply to claims system processing.
Adaptability: adjusts planned work by gathering relevant information and applying critical thinking to address multiple demands and competing priorities in a changing environment. Ability to successfully work with multiple priorities (multi-tasking) while maintaining a very high degree of accuracy on detail-oriented tasks.
Accountability: Accepts responsibility for own actions and decisions and demonstrates commitment to accomplish work in an ethical, efficient, and cost-effective manner. Ability to work interdependently to analyze design concepts and system modifications for thoroughness, accuracy, and compliance with federal and state standards.
Self-Management: Sets well-defined and realistic personal goals; displays a high level of initiative, effort, and commitment towards completing assignments in a timely manner; works with minimal supervision; is motivated to achieve; demonstrates responsible behavior. Ability to take initiative and to find new methods to improve work tasks with limited supervision.
To view the general description and example of duties for an Medicaid Program Specialist III please go to the following link: https://www.governmentjobs.com/careers/Alaska/classspecs
One year of professional experience as a Medicaid Program Specialist II with the State of Alaska or the equivalent with another employer.
Six years of any combination:
Post-secondary educational course work in public health, economics, public policy, legal studies, finance, business, or computer sciences from an accredited college (2.67 semester or 4 quarter hours equals 1 month)
Experience in health insurance administration, health insurance management information system, or health insurance finance and accounting; experience monitoring medical or public assistance programs for fraud or quality; experience conducting policy research and analysis; experience drafting health insurance policy; experience developing health insurance programs; experience examining medical claims, coding, billing, or patient information for reimbursement; or experience in a medical or healthcare field.
Certification as a Program Integrity Professional, Professional Coder, Professional Biller, Medicaid Professional, or other equivalent certification will substitute for one year of the required education and/or experience.
Additional Required Information
At time of interview applicant must submit:
A list of three (3) professional references, including daytime telephone numbers. At least one (1) must be from a current or former supervisor;
Copies of your three (3) most recent performance appraisals. If unavailable, supervisory letters of reference may be substituted.
A copy of academic transcripts (unofficial are acceptable but must include the institution name/URL on documents provided)
If substituting education for experience requirements, please provide copies of relevant documentation (transcripts, degrees)
Please read the below information carefully. This applies to your application submission.
For your application to be evaluated you must answer the Supplemental Questions. Be specific in your answers and tell us how you acquired the relevant experience. Please use complete sentences and proof-read your submissions when answering the supplemental questions. Your responses will be considered a writing sample and will be used to determine which applicants will advance to the interview phase of the recruitment process.
A cover letter is required. The cover letter must describe your knowledge, skills, abilities, as they pertain to the competencies listed in the job description above. Please attach the cover letter as a separate document to your application before applying online. If unable to attach to your application, email or fax the cover letter to the contact number provided in the job posting prior to the closing date of this recruitment. Omission of any required documentation will result in an incomplete application and you will not receive further consideration.
To verify education being used to meet the required minimum qualifications, you must fill in the Education section of the application. If you have not obtained a degree, please indicate the number of units completed. Copies of transcripts are required to verify educational credentials being used to meet the minimum qualifications for a position and are required with each application. (Unofficial are okay, please ensure that the institution/URL name is listed on the transcripts). Transcripts can be attached at the time of application, provided at the time of interview or if not provided, transcripts will be required prior to appointment.
SPECIAL INSTRUCTIONS FOR FOREIGN EDUCATION
Education completed in foreign colleges or universities may be used to meet the above requirements, if applicable. If utilizing this education you must show that the education credentials have been submitted to a private organization that specializes in interpretation of foreign educational credentials and that such education has been deemed to be at least equivalent to that gained in conventional U.S. education programs; or an accredited U.S. state university reports the other institution as one whose transcript is given full value, or full value is given in subject areas applicable to the curricula at the state university. It is your responsibility to provide such evidence when applying. Omission of required documentation listed will result in an incomplete application and you will not receive further consideration.
When using work experience not already documented in your application, please provide the employer name, your job title, dates of employment, and whether full-or part-time. Applications will be reviewed to determine if the responses are supported and minimum qualifications are clearly met. Work experience needed to meet the minimum qualifications must be documented in the application. If the application does not support minimum qualifications, the applicant may not advance to the interview and selection phase of the recruitment. A resume will not be used to determine that minimum qualifications have been met for the position in which you are applying.
If you are currently or previously been appointed to a flexibly staffed position please ensure your work experience within a flexibly staffed position indicates the actual dates employed at each level. Ensure your time and any subsequent flex promotion(s) are documented as a separate position. This is required as there are minimum qualifications that require experience at a particular level in which the lower level may not be considered. If this information is not accurately reflected in your application this may cause the processing of your application for consideration to be delayed.
NOTE: Attaching a resume or curriculum vitae is not an alternative to filling out the application in its entirety. Noting "see resume or CV" or any similar response on any portion of your application may lead to a determination your application is incomplete and removal from consideration for this job posting.
The State of Alaska does not provide VISA Employer sponsorships.
This position is open to Alaska Residents only. Please check our residency definition to determine if you qualify.
You can ONLY apply for this position through the Workplace Alaska website or via hardcopy application. If you accessed this recruitment bulletin through a job search portal such as ALEXsys or any other database, you MUST use a Workplace Alaska online or hardcopy application to successfully apply. Instructions on how to apply with Workplace Alaska may be found on the Workplace Alaska "How to Apply" webpage, found here: http://doa.alaska.gov/dop/workplace/help/
Questions regarding the application process can be directed to the Workplace Alaska hotline at 800-587-0430 (toll free) or (907) 465- 4095. If you choose to be contacted by email, please ensure your email address is correct on your application and that the spam filter will permit email from the 'govermentjobs.com' domains. For information on allowing emails from the 'governmentjobs.com' domains, visit the Lost Password Help page located at https://www.governmentjobs.com/OnlineApplication/User/ResetPassword.
The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA). Individuals with disabilities, who require accommodation, auxiliary aides or services, or alternative communication formats, please call 1-800-587-4095 in Juneau or TTY: Alaska Relay 711 or 1-800-770-8973 or correspond with the Division of Personnel & Labor Relations at: P. O. Box 110201, Juneau, AK 99811-0201. The State of Alaska is an equal opportunity employer.
WORKPLACE ALASKA APPLICATION QUESTIONS & ASSISTANCE
Questions regarding application submission or system operation errors should be directed to the Workplace Alaska hotline at 1-800-587-0430 (toll free) or (907) 465-4095 if you are located in the Juneau area. Requests for information may also be emailed to firstname.lastname@example.org.
For applicant password assistance please visit: https://www.governmentjobs.com/OnlineApplication/User/ResetPassword
For specific information in reference to the position please contact the hiring manager at:
Name: Billy Blixt, Administrative Officer I
Careers with the State of Alaska offer MANY benefitsThe following information describes typical benefits available to employees of the State of Alaska. Actual benefits received may differ by bargaining unit or branch of government, position type, or be prorated for other than full time work.For a quick breakdown of the insurance, health, and retirement benefits available for State Employees you can view an orientation video from Division of Retirement and Benefits. (Please note this video is specifically designed for new State Employees.)Insurance Benefits Health insurance, which includes employer contributions toward medical/vision/dental The following employee groups are under AlaskaCare Benefits administered by the State: See http://doa.alaska.gov/drb/programs/index.html for additional information. AVTEC Confidential Correctional Officers Marine Engineers Mt. Edgecumbe Teachers Supervisory Unlicensed Vessel Personnel/Inland Boatman's Union Exempt employees (not covered by collective bargaining) The following employee groups are covered by Union health trusts. Contact the appropriate Union for additional information. General Government Labor, Trades and Crafts Public Safety Employees Association Masters, Mates & Pilots Employer paid Basic Life insurance with additional coverage available (amount depends on Bargaining Unit)Optional Insurance Benefits Group-based insurance premiums for Term life (employee, spouse or qualified same sex partner, and dependents) Long-term and short-term disability Accidental Death and Dismemberment Long-term care (self and eligible family members) Supplemental Survivor Benefits Employee-funded flexible spending accounts for tax savings on eligible health care or dependent care expensesRetirement Benefits Membership in the Public Employees Retirement System (PERS)/Teachers' Retirement System (TRS) Matching employer contribution into a defined contribution program (new employees) Employer contribution into a defined benefit or defined contribution program (current employees) Contributions to the Alaska Supplemental Annuity Plan in lieu of contributions to Social Security Option to enroll in the Alaska Deferred Compensation Program Note: The Defined Contribution Plan, Supplemental Annuity Plan and Deferred Compensation Program offer a variety of investment optionsSee http://doa.alaska.gov/drb/retirement/index.html for additional information Paid Leave & Other Benefits Personal leave with an accrual rate increase based on time served Eleven paid holidays a year Gym discounts at participating fitness providers in multiple locations throughout the state.See http://doa.alaska.gov/drb/ghlb/employee/health/gymListing.html for additional information