Posted on

Medicaid Pre-Release Enrollment – Coordinator 2 – Baton Rouge, LA

Clipped from: https://www.indeed.com/viewjob?jk=1f6c903e10157f2e&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Indeed’s salary guide

  • Not provided by employer
  • $58.8K – $74.4K a year is Indeed’s estimated salary for this role in Baton Rouge, LA.

Thank you for your interest in The University of New Orleans.

Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting.

You must complete all required portions of the application and attached the required documents in order to be considered for employment.

Department

Compliance Operations

Job Summary

The MPRE Coordinator 2 position is part of a three-member team that supports Medicaid’s Justice-involved Pre-Release Enrollment Program as well as other justice-involved initiatives undertaken by Medicaid. The Pre-Release Enrollment Program provides Medicaid coverage for the offender population and is a collaborative effort, working with the Louisiana Department of Public Safety & Corrections (DPS&C) and partners with community groups that work with formerly incarcerated persons. A key role of this position will be to advance the monitoring and evaluation of the program. This position is domiciled at the Louisiana Department of Health’s office in Baton Rouge, Louisiana.

Job Description

  • Assist the LDH Program Manager in all areas of daily program functions including researching Medicaid eligibility and resolving application issues, ensuring the accuracy of program data, communicating with stakeholders, and periodic program monitoring.
  • Work collaboratively with staff of DPS&C’s prison facilities, Medicaid’s managed care plans, and other LDH programs.
  • Assist with the coordination, planning and evaluation of Medicaid’s Pre-release Enrollment Program and other justice-involved initiatives
  • Assist LDH management with day-to-day tasks and serve as a secondary contact and provide functional back-up support in the unit supervisor’s absence.
  • Research multiple databases to resolve individual Medicaid application and enrollment issues for internal and external partners.
  • Responsible for data analysis and writing monthly, mid-year and annual reports.
  • Represent the department at relevant conferences, regional events and stakeholder meetings. Some in-state travel is expected, including travel to other state offices and correctional facilities.
  • Conduct research on topics related to program or target population as needed.
  • Assist with the preparation and execution of conference calls, webinars, and meetings.
  • Develop and update documentation about the program for internal and external audiences such as operations manuals, reports, white papers, abstracts and fact sheets.
  • Facilitate meetings, trainings as needed.
  • Assist with data integrity efforts including verifying data accuracy.
  • Other tasks as directed.

QUALIFICATIONS

REQUIRED:

  • Bachelor’s degree.
  • Minimum of 1 year professional experience in Medicaid programs, the justice-involved population, or criminal justice system.
  • Minimum 1 year of professional experience with writing business documents such as reports, abstracts and memorandums.
  • Minimum of 1 year of professional experience with planning and leading meetings, committees, or coalitions.
  • Advanced ability to problem-solve and research between multiple computer systems or databases.
  • Proficient in Microsoft Office applications, including Word, Excel, Access and Power Point.
  • Strong verbal and written communications skills and ability to communicate concepts to a range of audiences. .
  • Must be able to pass a background check and gain admittance to correctional facilities.

DESIRED:

  • Master’s degree in health administration, business administration, information technology, or public health, Juris Doctor or other advanced degree in relevant field.
  • Minimum of 2 years professional experience in Medicaid programs, the justice-involved population, or criminal justice system.
  • Minimum of 1 year professional experience with data analysis software such as SAS, SQL, R, Python.
  • Experience with scholarly journal article writing, submissions and publications.
  • Experience with health outcomes/policy research or study/survey design.

Required Attachments

Please upload the following documents in the Resume/Cover Letter section.

  • Detailed resume listing relevant qualifications and experience;
  • Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems;
  • Names and contact information of three references;
  • Diversity Statement (required for all Faculty positions and any Staff position of Assistant Manager and higher).

See Diversity Statement instructions by clicking this link:

https://www.uno.edu/careers/diversity-instructions

Applications that do not include the required uploaded documents may not be considered.

Posting Close Date

This position will remain open until filled.

Note to Applicant:

Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.

References will be contacted at the appropriate phase of the recruitment process.

This position may require a criminal background check to be conducted on the candidate(s) selected for hire.

As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.

The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.

Posted on

Oklahoma Medicaid CFO, Nicoma Park, Oklahoma

Clipped from: https://starjobsearch.co.uk/jobs/oklahoma-medicaid-cfo-nicoma-park-oklahoma/945468666-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Oklahoma Medicaid CFO

At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us and start doing your life’s best work.(sm)

 
 

This position is accountable for the day-day development and management of financial models and performance as it relates to business goals and objectives in the Oklahoma Community & State health plan. This position will work with key leaders to ensure that the business is operating effectively, with sound financial analysis, and with appropriate financial and operating controls in place.

 
 

Primary Responsibilities:

 
 

 
 

  • Confirms compliance with the SoonerSelect program regulatory requirements (e.g., quarterly/annual filings) and other program operational areas (e.g., rate changes, fee-schedule changes, revenue reconciliation, reporting) and oversees all audit activities

 
 

  • Develops, performs and manages analyses of business/financial metrics and performance measures and reports financial and operational data to region/site leaders

 
 

  • Develops and maintains financial reports to clearly communicate actual results, forecasted performance, and variances to plan, forecast and budget

 
 

  • Works closely with health plan executives to develop, recommend and establish strategies, plans and processes to improve profitability and cost efficiencies

 
 

  • Leads the financial management of capital, operating expense and develops metrics, benchmarks, and analytics to guide the appropriate investment in infrastructure

 
 

  • Establishes detailed budgets and identifies, quantifies, and prioritizes strategic initiatives to realize these budgets

 
 

  • Assists with trend analysis and forecasting

 
 

  • Assists with development and operationalizing medical cost reporting

 
 

  • Engages in monthly close process

 
 

 
 

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

 
 

RELOCATION IS AVAILABLE

 
 

Required Qualifications:

 
 

 
 

  • Bachelor’s degree in Finance, Accounting, or equivalent field

 
 

  • 8+ years of broad experience in multiple Finance disciplines

 
 

  • Experience reporting to Executive Leadership in a strategic partnership capacity

 
 

  • Advanced knowledge of Health Care industry (2+ years minimum of healthcare finance experience)

 
 

  • Solid working knowledge of financial systems, statements and reports

 
 

 
 

Preferred Qualifications:

 
 

 
 

  • MBA or CPA

 
 

  • Medicaid and/or Medicare experience

 
 

  • Demonstrated success partnering with leading and influencing multiple teams responsible for complex operations

 
 

  • Ability to complete complex projects and influence change in complicated, fast paced, matrix environment

 
 

 
 

Posted on

PRODUCT MANAGER ( MEDICARE ADVANTAGE, MEDICAID) | Bestinfo Systems LLC

Clipped from: https://www.linkedin.com/jobs/view/product-manager-medicare-advantage-medicaid-at-bestinfo-systems-llc-3520895550/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

PRODUCT MANAGER ( MEDICARE ADVANTAGE, MEDICAID)_ALL USA_Full-Time(FTE)

 
 

Hi,

Greetings from Bestinfo Systems LLC!!

We have a job opportunity that matches your profile.

Kindly check the below position and revert me with your updated resume along with salary expectations and location preference

 
 

Job Title: PRODUCT MANAGER ( MEDICARE ADVANTAGE, MEDICAID)

Location: The job is fully remote, no location is specified

Job Type: Full-Time(FTE)

Industry: Healthcare / Health Services

Job Category: Medical / Health – Other Medical / Health

 
 

Job Description:

Primary duties may include, but are not limited to:

Evaluates existing products and competitor and industry data to improve existing products and make recommendations for new products.

Coordinates presentation, communication, and implementation of all phases of product development.

Ensures products meet competitive, regulatory (CMS, NCQA), and compliance needs.

Reviews analyze, and makes recommendations on actions for existing products.

Investigates market opportunities and effect on the market for existing and new products.

Identifies system needs to support short- and long-term product strategy.

 
 

Qualifications:

Requires a BA/BS degree in a related field and a minimum of 2 years of related experience(Or)

Any combination of education and experience would provide an equivalent background.

 
 

Preferred Skills, Capabilities, and Experience:

MBA

Health or managed care experience

Strong strategic managed care understanding for Medicare Advantage, Medicaid, and Commercial and chronic complex populations.

Extensive knowledge of CMS, and NCQA regulatory guidelines.

Aptitude for independent strategic thinking as well as the ability to identify, leverage, and execute best practices while demonstrating a continuously innovative mindset.

Critical thinker/problem solver is willing to take initiative with minimal direction.

 
 

SKILLS AND CERTIFICATIONS:

Healthcare Experience

medicare advantage

Medicaid

 
 

IDEAL CANDIDATE:

Strong strategic managed care understanding for Medicare Advantage, Medicaid, and Commercial and chronic complex populations.

Extensive knowledge of CMS, and NCQA regulatory guidelines.

Posted on

LTSS Medicaid Operations Director – Remote at UnitedHealth Group

Clipped from: https://www.themuse.com/jobs/unitedhealthgroup/ltss-medicaid-operations-director-remote?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

This subject matter expert role will provide insights into long term care services (LTSS) operational complexity to support of fully/partially integrated programs. This leadership role supports product fluidity to comply with CMS guidance directing payers to prepare to have fully integrated Medicare/Medicaid capabilities going forward.


You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.


Primary Responsibilities:


 

  • Provide program operational and regulatory expertise for LTSS/HCBS integrated services including but not limited to assessment, service planning, care coordination, transition planning, consumer hearings, member and caregiver education and training, compliance with program requirements, rules, and regulation
  • Partner with provider relations team to develop content to support provider management functions for Providers of HCBS services including but not limited Support content for program policies procedures and protocols that are aligned with federal and state requirements and community education program
  • Contribute to strategies which foster best in class service to the Health Plan, State Department of Medicaid, CMS and Corporate
  • Contribute to the operational strategic vision, objectives, policies, and procedures related to LTSS/HCBS
  • Identify operational efficiencies; meet regulatory and corporate expectations and develop a “best practice” approach to the defined operational areas
  • Identifies tactics to meet and exceed requirements including organizational, state, accreditation, compliance, and contractual agreements
  • Assess program strengths and weaknesses to recommend and deliver enhanced operating model
  • Participate in business development and membership growth including procurement and re-procurement activities

You’re ready to take on an incredibly challenging marketplace of ideas, products, and services. But are you up for leading the transformation of an entire industry? Here, you’ll work with the smartest people on solving the most important problems our nation is facing. The tasks are huge, the impact is far-reaching -it’s the best chance to test your mettle on a global stage.


You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


Required Qualifications:

 

  • Undergraduate degree or equivalent experience
  • 5+ years of experience with managed healthcare, preferably in Medicaid ABD, LTSS and/or Medicare
  • Demonstrated exceptional verbal (e.g., Public Speaking) Writing /Composing: Correspondence /Reports Analytical, MS Word, MS Excel

Preferred Qualification:

 

  • 3+ years management experience

Already Fortune 5, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we’re doing a lot of good.

Through our family of businesses and a lot of inspired individuals, we’re building a high-performance health care system that works better for more people in more ways than ever. Now we’re looking to reinforce our team with people who are decisive, brilliant – and built for speed.


Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.


California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $118,000 to $226,800. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.


*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy



At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.



UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Posted on

Ohio Medicaid Inbound Contact Representative

Clipped from: https://us.jobrapido.com/jobpreview/2831448068?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Back to search: Ohio Medicaid / Cincinnati, OH

Cincinnati, OH – Ohio

Humana

Other jobs like this

full time

Published on www.appcast-cpc.com 14 Mar 2023

DescriptionThe Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.ResponsibilitiesThe Inbound Contacts Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members. Records details of inquiries, comments or complaints, transactions or interactions and takes action accordingly. Escalates unresolved and pending customer grievances. Decisions are typically focus on interpretation of area/department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Required Qualifications: Minimum 2 years of customer service experience. Demonstrated experience with providing exceptional customer service and attention to details while listening on calls. Prior experience managing multiple or competing priorities, including use of multiple computer applications simultaneously. Prior experience effectively communicating with customers verbally and listening to their needs. Must be able to accurately and completely document member needs, inquiries, or questions during calls within multiple systems. Location: MUST reside in the State of Ohio Required Work Schedule: This role starts on April 17, 2023. Virtual Training will start day one of employment and runs for the first 7 weeks with a schedule of 8:00 am – 4:30 pm EST, Monday – Friday. Attendance is vital for success, so no time off is allowed during training or within your first 120 days, with the exception of observed (and paid) company holidays. Following training, must be available to work any 8-hour shift between the hours 6:45 am – 8:00 pm EST, Monday – Friday (subject to change based on business needs). Some weekends and overtime may be required based on business needs. Preferred Qualifications: What you need to STAND OUT among the crowd: Associates or Bachelors Degree Prior inbound call center or related customer service experience Prior healthcare experience Bilingual in English and Spanish (potential increase in hourly rate for bilingual skills; see Additional Information below) Proficiency with Microsoft Office applications, particularly Outlook and MS Teams Additional Information Please be advised, any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Candidates must be tested in ALL languages listed on the description. Work at Home GuidanceTo ensure Home or Hybrid Home/Office associates ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.Satellite, cellular and microwave connection can be used only if approved by leadership.Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Additional InformationPlease be sure to include your resume with your application!As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a first round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isnt missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. ALERT : Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humanas secure website. #LI-REMOTEScheduled Weekly Hours40

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Vice President Business Development (Medicaid / Healthcare) – Irvine, CA

Clipped from: https://www.indeed.com/viewjob?jk=fc49d4e19b131329&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Benefits

Pulled from the full job description

401(k)

401(k) matching

AD&D insurance

Dental insurance

Dependent health insurance coverage

Disability insurance

Employee assistance program

Health insurance

Paid sick time

Paid time off

Tuition reimbursement

Vision insurance

Wellness program

Tooth be told, you’ll love working with us.

LIBERTY Dental Plan is seeking a Vice President to provide strategic oversight of business development and generate new business opportunities by strategizing, qualifying and identifying secure business opportunities that will positively impact the growth and profitability of the company.

JOB SUMMARY

  • Plans and coordinates LIBERTY’s business development strategy, in accordance with organizational goals.
  • Identifies new business opportunities and manages relationships through the business development lifecycle.
  • Strengthen existing and new business relationships using a working knowledge and understanding of the industry, client regulatory requirements, and LIBERTY’s operations and innovation.
  • Build and manage a high-performing national sales team.
  • Represent LIBERTY at industry conferences, trade shows, events, and client meetings across the U.S.
  • Develop and maintain positive organizational culture, values and reputation in its markets and with all staff, clients, providers, partners and regulatory/official bodies.
  • Perform other duties as assigned.

WHAT YOU’LL NEED

  • Minimum 14 years’ experience in business development and sales; preferably in government programs with focus on Medicaid or Managed Care
  • Minimum 4 Year bachelor’s degree in business, Marketing or related, or equivalent combination of experience and education.
  • Strong negotiation and influential skills
  • Strong understanding of the health insurance industry and Medicaid/Medicare Advantage, dental highly preferred
  • Previous corporate sales and/or consulting expertise required
  • Management skills – prior experience in sales leadership required
  • Client relationship skills – ability to develop strong professional relationships
  • Effective communication (verbal and written) and presentation skills
  • Results driven – focused on producing high-quality services and deliverable
  • Computer literacy with ability to easily acquire working knowledge of new system applications. Possess, at minimum, basic Microsoft (Excel, Word and PowerPoint) skills

LOCATION

Near one of our primary offices is highly preferred. LIBERTY offices are located in Irvine, CA, Las Vegas, NV, Oklahoma City, OK and Tampa, FL. Our employees are distributed in office locations in multiple markets across the United States. We are unable to hire or allow employees to work outside of the United States.

WHAT LIBERTY OFFERS

Happy, healthy employees enhance our ability to assist our members and contribute more actively to their society. That’s why LIBERTY offers competitive and attractive benefit packages for their employees. We strive to care for employees in positive ways that promotes wellness and productive employees.

Our first-class benefit package supports our employees and their dependents with:

  • Competitive pay structure and saving options that help you reach your financial goals!
  • Excellent 401k plan that matches 100% up to 3%. 50% match at 4% and 5%; immediate vesting during Safe Harbor period and professional financial advice through Financial Engines!
  • Medical Insurance at no charge for employee only coverage. LIBERTY subsidizes 50% of eligible dependent coverage! Company offers PPO and HMO (where available) options.
  • 100% paid dental coverage for your ENTIRE eligible Family members!
  • 100% paid vision coverage for employee only coverage, low premium for dependents!
  • Company paid basic life and AD&D coverage; options to elect additional supplemental coverage.
  • Long Term Disability coverage
  • Generous wellness program
  • Employee Assistance Program
  • 10 days paid vacation, 10 paid holidays including 2 days each for Thanksgiving, Christmas and New Years and a floating holiday granted for your birthday!
  • 6 paid sick days annually with the ability to roll time over!
  • Tuition Reimbursement
  • Remote or Hybrid options for various positions
  • And so much more…

COMPENSATION

In the spirit of pay transparency, we are excited to share the base salary for this position is $200,000 – $283,634, exclusive of fringe benefits or potential bonuses. If you are hired at LIBERTY, your final base salary compensation will be determined based on factors such as geographic location, skills, education, and/or experience. In addition to those factors – we believe in the importance of pay equity and consider internal equity of our current team members as a part of any, final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical in order to allow for future & continued salary growth.

LIBERTY Dental Plan commits to maintaining a work environment that acknowledges all individuals within the workplace and will continue to engage in practices that are inclusive of all backgrounds, experiences, and perspectives. We strive to have every person within the organization have a sense of belonging while encouraging individuals to unleash their full potential. LIBERTY will leverage diverse perspectives in building high performance teams and organizational culture.

LIBERTY Dental Plan will continue to strengthen and develop external partnerships by providing equitable health care access and improving population health in the communities we serve.

We comply with all applicable laws and regulations on non-discrimination in employment, recruitment, promotions, and transfers, as well as work authorization and employment eligibility verification requirements.

Sponsorship and Relocation Specifications:

LIBERTY Dental Plan is an Equal Opportunity Employer / VETS / Disabled.

No relocation assistance or sponsorship available at this time.

Posted on

MEDICAID REGIONAL ADMINISTRATOR Job in Baton Rouge, LA at State of Louisiana

Clipped from: https://www.ziprecruiter.com/c/State-of-Louisiana/Job/MEDICAID-REGIONAL-ADMINISTRATOR/-in-Baton-Rouge,LA?jid=7f02a1b94d9033fa&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Tangipahoa Parish


Announcement Number: MVA/PJ/172991
Cost Center: 305-2050410
Position Number(s): 50381201


This vacancy is being announced as a Classified position and may be filled as a Probationary or Promotional appointment.


No Civil Service test score is required in order to be considered for this vacancy.


To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.


*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*


A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit


For further information about this vacancy contact:
Paula Jackson

paula.jackson@la.gov
LDH/HUMAN RESOURCES

BATON ROUGE, LA 70821
225 342-6477


This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

MINIMUM QUALIFICATIONS:

A baccalaureate degree plus five years of professional level social services experience, two years of which must have been as a supervisor of two or more professionals.

SUBSTITUTIONS:
Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:


A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.


30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.

60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.
90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.
120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience tosubstitute for the baccalaureate degree.

Graduate training will substitute for a maximum of one year of the required general work experience on the basis of thirty semester hours for one year of experience.

A master’s degree will substitute for one year of the required general experience.

A Juris Doctorate will substitute for one year of the required general experience.

Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required general experience.

A Ph.D. will substitute for two years of the required general experience.

Advanced degrees will substitute for a maximum of two years of the required general experience.

NOTE:
Any college hours or degree must be from an accredited college or university.

FUNCTION OF WORK:

To serve as administrator for a region of the state.

LEVEL OF WORK:

Administrator.

SUPERVISION RECEIVED:

A Medicaid Regional Administrator typically reports to a Program Manager 4-DHH. May receive supervision from higher level personnel.

SUPERVISION EXERCISED:

Subordinate staff typically includes an Assistant Medicaid Regional Administrator. May supervise lower level personnel.

LOCATION OF WORK:

Department of Health and Hospitals, Medical Vendor Administration.

JOB DISTINCTIONS:

Differs from Medicaid Assistant Regional Administrator by the presence of overall responsibility for Medicaid eligibility activities in a region.

Differs from Program Manager 4-DHH by the absence of statewide responsibility for all Medicaid eligibility activities.

EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Directs the regional execution of Medicaid programs by establishing priorities, evaluating efficiency, quality and compliance with federal and state regulations, and taking corrective action as necessary.

Directs the preparation of regional annual budget requests, oversees fiscal matters (payroll, purchasing, procurement, leasing, etc.) and physical plant management for a regional facility and all local branch units within a region.

Interviews, hires and evaluates staff and recommends and/or approves the appointment, promotion, discipline or dismissal of staff in accordance with applicable rules.

Proposes recommendations concerning staffing needs and assesses the effects of established caseload standards upon staff performance and productivity.

Coordinates the operation of programs and the work of various disciplines throughout the region.

Serves as liaison with representatives of local, state, federal and private agencies and organizations, the general public, and governmental officials.

Oversees the planning and implementation of staff development programs throughout the region.Employment Type: Classified

Posted on

SAS Programmer II/Medicaid Job California

Clipped from: https://www.learn4good.com/jobs/online_remote/info_technology/2176578843/e/

Position:  SAS Programmer II (Medicaid)
Overview

AIR is currently seeking a Medicaid SAS Programmer II to join our Health team. The SAS Programmer II will be highly proficient in the application of SAS programming to administrative health data. The ideal candidate will participate in all aspects of AIR’s current projects. Primary responsibilities include performing a variety of tasks related to data collection, statistical and qualitative data analysis, report writing, and data manipulation.


Our Health team works collaboratively to unravel the intertwined challenges of health care quality, costs, and access. Our team of experts – nurses, physicians, psychologists, economists, sociologists, data scientists, and public health experts – advance evidence and save lives by leading rigorous research and evaluation; results-driven technical assistance and training; and leading-edge data science and technology tools.


Use your experience, knowledge, and education to help us deliver on our mission: to contribute to a better, more equitable world.


Candidates hired for the position may work remotely within the United States (U.S.) or from one of our U.S. office locations.


About AIR:


Established in 1946, with headquarters in Arlington, Virginia, AIR is a nonpartisan, not-for-profit institution that conducts behavioral and social science research and delivers technical assistance to solve some of the most urgent challenges in the U.S. and around the world. We advance evidence in the areas of education, health, the workforce, human services, and international development to create a better, more equitable world.


AIR’s commitment to diversity goes beyond legal compliance to its full integration in our strategy, operations, and work environment. At AIR, we define diversity broadly, considering everyone’s unique life and community experiences. We believe that embracing diverse perspectives, abilities/disabilities, racial/ethnic and cultural backgrounds, styles, ages, genders, gender identities and expressions, education backgrounds, and life stories drives innovation and employee engagement. Learn more about AIR’s Diversity, Equity, and Inclusion Strategy and hear from our staff by clicking here.


Responsibilities


The responsibilities for the position include:


* Convert datasets among SAS, STATA, mainframe databases and other formats


* Extract, recode, merge, and de-duplicate datasets


* Perform outlier analyses, handle missing data, and create analysis variables


* Perform statistical analyses


* Create customized reports of data analysis results


* Create quality computer generated data listings, summary tables and data collection studies


* Provide technical oversight and training to junior SAS Programmers


* Analyze code to find causes of errors and revise programs


* Write and maintain documentation of changes to computer code, programs, and specifications


* Write technical reports and proposals


* Performing other related duties as assigned


Qualifications


Education , Knowledge, and


Experience:


* Undergraduate degree in Statistics, Epidemiology, Economics, Public Health, or Date Science


* 3 years’ experience working directly with Medicaid administrative claims data


* Highly experienced in writing programming code to produce logic checks, derived datasets, summary tables, and figures for data collected via project work


* 5 years hands-on SAS experience


* Experience with CMS Medicaid and Medicare research identifiable files (RIF) data and working in the CMS virtual research data center (VRDC) environment preferred but not required


* Proposal preparation and management experience helpful but not required


* SAS certification preferred but not required


* Experience applying SAS in a health research environment preferred but not required


* Skills:


* Skilled in all aspects of data processing management


* Excellent organizational skills


* Good communication skills


* Able to learn quickly and work in a team, collaborative environment


Disclosures:


AIR requires all new hires to be fully vaccinated against COVID-19 or receive a legally required exemption from AIR, as a condition of employment. AIR will ask candidates to verify their vaccination status only after a conditional offer of employment is made. Applicants should not provide information about their vaccination status or need for exemption prior to receiving a conditional offer of employment from AIR


Applicants must be currently authorized to work in the U.S. on a full-time basis. Employment-based visa sponsorship (including H-1B sponsorship) is not available for this position. Depending on project work, qualified candidates may need to meet certain residency requirements.


All qualified applicants will receive consideration for employment without discrimination on the basis of age, race, color, religion, sex, gender, gender identity/expression, sexual orientation, national origin, protected veteran status, or disability.


AIR adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and…

Posted on

Blue Cross Blue Shield of Illinois, Montana, New Mexico, Oklahoma & Texas | HCSC Associate Medicaid Operations Specialist Job in Chicago, IL

Clipped from: https://www.glassdoor.com/job-listing/associate-medicaid-operations-specialist-blue-cross-blue-shield-of-illinois-montana-new-mexico-oklahoma-and-texas-hcsc-JV_IC1128808_KO0,40_KE41,118.htm?jl=1008530821209&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!

Job Summary

This position is responsible for providing assistance to the Medicaid operations specialist on operational services, works with Medicaid operational specialist with program implementation and coordination for one or more of the day-to-day Medicaid operation functions (eg billing, claims enrollment, encounter submissions and customer service). This associate is responsible for assisting the Medicaid operations specialist on researching to resolve complex and / or escalated internal or external operational questions. Additionally, this position works with other areas of the organization on the development, testing, and implementation of program policies, business processes, and system changes to ensure the state requirements of the plan are met.

JOB REQUIREMENTS:

  • Bachelor Degree in Business with 1-year experience OR 5 years of experience working in health insurance operations.
  • Experience interfacing with internal clients, customers and operations personnel.
  • Verbal and written communication skills and ability to assist in representing Medicaid department at committee meetings.
  • Experience with interacting effectively with all levels of internal and external customers.
  • Experience managing multiple projects effectively.
  • Interpersonal, organizational and analytical skills.
  • Experience with claims, customer service and membership services
  • Experience with analytics
  • Organizational skills.

PREFERRED JOB REQUIREMENTS:

  • Member encounters and reconciliation

Please note: This role will work in the office three days a week.

We encourage people of all backgrounds and experiences to apply. Even if you don’t think you are a perfect fit, apply anyway – you might have qualifications we haven’t even thought of yet

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

Posted on

Medicaid Eligibility Business SME | NTT DATA Services

Clipped from: https://www.linkedin.com/jobs/view/medicaid-eligibility-business-sme-at-ntt-data-services-3527654163/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Req ID: 233018


NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.


We are currently seeking a Medicaid Eligibility Business SME to join our team in Nashville, Tennessee (US-TN), United States (US).


The Medicaid Eligibility Subject Matter Expert (SME) will work directly with the client’s operations staff to assist with ongoing system enhancement work. This includes but is not limited to participation in definition, design, testing and implementation of changes in each of the system releases. This Medicaid Eligibility SME will be a valued member of the client’s Business Services Support team. The Medicaid Eligibility SME will work collaboratively with the client and other vendors on the client’s projects and initiatives. The Medicaid Eligibility SME will provide valuable business analysis services and subject matter expertise through consultation with the client. The Medicaid Eligibility SME will integrate seamlessly with the client team to ensure that business needs are met by managing and driving change using knowledge and experience.


The Medicaid Eligibility SME will assist the team with implementing these changes driven by requirements definition through final implementation and stabilization. The NTT DATA staff will perform the follow responsibilities:


  • Work collaboratively with the Member Services team(s) leveraging their Eligibility business operations skills and expertise as well as their systems implementation experience, to improve the operational efficiency of the team and increase the quality of the systems enhancements and changes that go into production.
  • Work collaboratively with the Member Services Partner Support team supporting onboarding and administrative tasks, including trouble shooting and problem solving.
  • Participate in identifying any operational impacts created by proposed system changes and recommend modifications to business workflow and processes.
  • Participate in requirements definition and design, business workflow development, design, and improvement, the review of system integration test case and results, and the review of user acceptance test case and results.
  • Participate in implementation planning and execution activities, such as operational readiness tests, parallel tests, and beta tests.
  • Develop and execute Eligibility Business Operations Test Cases as part of the User Acceptance phase for each system release.
  • Collaborate with the Enterprise Testing Management Office (eTMO) to ensure that testing standards and processes are maintained as the Eligibility Business Operations Test Cases are executed and defects are identified.
  • Employee is expected to undertake any additional duties as they are assigned by their manager.

     

Basic Qualifications:


  • Bachelor’s degree or 4 Years additional equivalent experience
  • Minimum of 5 years of experience including:
  • A minimum of 3 years’ experience conducting meetings and making presentations
  • A minimum of 2 years’ experience demonstrating strong problem-solving and customer service skills
  • A minimum of 1 year of business experience working on large complex system implementation and/or enhancement projects
  • A minimum of 3 years’ experience interacting with vendors and third parties effectively to meet commitments and milestones.
  • A minimum of 1 year testing experience
  • Must be able to travel to Nashville, Tennessee 50% of the time, post COVID-19 restrictions


     

Preferred Skills:


  • Experience interpreting complex eligibility determination rules, policy, and processes
  • Experience in the health and human services related industry
  • Ability to work independently and manage work to a defined schedule
  • Strong written and verbal communication skills
  • Team player and a consistent, dependable performer with an excellent work ethic, flexible “can-do” attitude, and a results-driven commitment to success
  • Ability to apply industry best practices and future state/federal mandates to existing systems
  • Excels at using quantitative data to drive recommendations and decisions


     

For Colorado Candidates


In compliance with the Colorado Equal Pay Transparency Rules, NTT DATA provides a reasonable range of compensation for roles that may be hired in Colorado. For a candidate in the state of Colorado only, the starting pay range for this role is 72,700 to 85,000. Actual compensation will depend on a number of factors, including actual work location, relevant experience (internal or external), technical skills, and other qualifications.


This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally-required benefits.


About NTT DATA Services


NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.


NTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.