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Medicaid Consultant

 
 

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Company Overview: Public Consulting Group, Inc. (PCG) provides management consulting and technology services to help public sector education, health, human services, and other government clients achieve their performance goals and better serve populations in need. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has more than 2,500 professionals in 50 offices in the United States, Canada and Europe. The firm draws on more than two decades of consulting to public sector clients in all 50 states and Canada to deliver best-practice solutions and measurable results to state and local public agencies, state-operated facilities, and private providers that do business with government agencies. PCG is committed to a diverse workforce which is a reflection of our clients and the people they serve. Our organizational culture attracts and rewards people who are results-oriented and interested in making an immediate impact on their community as well as their own career. Subject Areas: Technology, with a focus on public assistance eligibility and/or Medicaid Management Information System (MMIS) systems and solutions. Client-facing consulting and relationship management services. Responsibilities The Senior Consultant has expertise in project management principles in accordance with the Project Management Body of Knowledge (PMBOK), ideally with experience with Agile development. The Technical Project Manager will have a specific focus on working with clients and technical delivery managers to define business, functional and technical requirements and oversee the development of solutions meeting these requirements. The Technical Project Manager will need to understand client projects both on a technical level (as a solution using web applications, databases and calculations to achieve a goal) and on a programmatic level (the Health Care Consulting goals being met by the technical solution). The Technical Project Manager will need to be comfortable leading clients, be a strong written and verbal communicator, be organized and detail-oriented, and be able to work effectively without oversight. The Technical Project Manager will directly manage individual projects, including overseeing the development of new technical solutions and the implementation of existing technical solutions. The Technical Project Manager will be responsible for drafting project management plans and work breakdown structures and monitoring progress throughout client implementations. The Technical Project Manager will be responsible for creating high quality project management artifacts and client reports and ensuring the timely submission of project deliverables. Specific Responsibilities: Oversee client relationships, needs, requirements and expectations Define project scope, schedule, goals and deliverables that support client needs and requirements Manage task execution and scheduling with clients, team members and other stakeholders Coordinate with internal business teams and technical delivery managers to ensure timely and high-quality results that meet or exceed clients expectations Develop and deliver progress reports, project management artifacts, requirements documentation, and client presentations Proactively manage changes in project scope, identify potential risk, and devise mitigation and contingency plans Analytic aptitude to evaluate business processes and make recommendations on solutions Provide operational support to projects after implementation Qualifications Required Experience: A Bachelor’s Degree is required. Master’s degree is preferred but not mandatory Minimum 5+ years technical project management experience PMP certification or similar qualification Minimum 2+ years business-to-government consulting and/or project management experience Minimum 2+ years of supervisory and/or management experience Outstanding oral and written presentation and communication skills Strong client management and relationship building aptitudes Strong quantitative skills and the ability to analyze and interpret data Strong attention to detail and ability to work autonomously in a fast-paced environment Entrepreneurial problem-solver able to take ownership of and be accountable for projects and relationships Willing to travel 10-20% regularly and up to 50% when needed Sets you apart: Government healthcare consulting experience Experience with MMIS and/or eligibility systems Medicaid programmatic and/or policy expertise Sales aptitude and ability #LI-AH1 #D-PCG

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Economist | Centers for Medicare & Medicaid Services

 
 

About the organization

 
 

The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many reforms of the Patient Protection and Affordable Care Act (PPACA) related to private health insurance. Within CCIIO, the Marketplace Plan Management Group (MPMG) administers the Federal-facilitated Health Exchange.

 
 

 
 

Duties

 
 

Are you interested in working with the United States Department of Health Human and Services to ensure affordable, quality health care coverage is available to all Americans? The Centers for Medicare and Medicaid Services (CMS) is seeking highly motivated team players with economic modeling and evaluation skills who are critical thinkers, creative problem solvers and analytically minded.

 
 

The Center for Consumer Information and Insurance Oversight (CCIIO) is charged with helping implement many reforms of the Patient Protection and Affordable Care Act (PPACA) related to private health insurance. Within CCIIO, the Marketplace Plan Management Group (MPMG) administers the Federal-facilitated Health Exchange, including:

 
 

  • reviewing and analyzing healthcare data for compliance with regulatory standards;
  • developing quantitative and qualitative analyses to inform policy development;
  • implementing and improving project management processes and data systems, and;
  • communicating with states, health insurance companies, and other key stakeholders regarding health plan data and program development.

 
 

 
 

The Division of Plan Analytics and Review needs a highly motivated candidate with strong economic modeling, project management, and critical thinking skills. A successful candidate will demonstrate ability to conduct program and policy analyses, as well as to complete complicated and large projects involving multiple stakeholders and systems. 

Clipped from: https://www.linkedin.com/jobs/view/economist-at-centers-for-medicare-medicaid-services-2735122622/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

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Compliance and Safety Check Supervisor (Medicaid Health Systems Administrator 1) | Ohio Department of Medicaid

 
 

The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. In 2020, ODM introduced a new vision for Ohio’s Medicaid program — one that strengthens Ohio’s future and ensures everyone has the chance to live life to its full potential.


Today, more than 90 percent of Ohio Medicaid members are supported by managed care organizations. During the year ahead, ODM will begin implementing a new vision for care; focusing on the individual, a strong partnership among MCOs and the department, and supporting specialization in addressing critical needs.


A program that puts the individual first


They Are


Adopting Governor DeWine’s philosophy of service to Ohioans, ODM embarked on an aggressive effort to redesign its managed care program. The goal is to provide more personal, holistic care and supports for millions of Ohioans served by Medicaid. Listening to feedback from more than 1,100 individuals and organizations we identified five procurement goals that would put the individual front and center of Medicaid’s program and policy decisions.

  • Emphasize a personalized care experience,
  • Improve care for children and adults with complex behavioral health needs,
  • Improve wellness and health outcomes,
  • Support providers in better patient care and
  • Increase program transparency and accountability.

Unless required by legislation or union contract, starting salary will be set at step 1 of the pay range.


Office: Health Innovation & Quality


Bureau: Clinical Operations


Classification: Medicaid Health Systems Administrator 1 (PN 20047533)


Job Overview


The Compliance and Safety Check unit consists of field staff who are headquartered in various locations throughout Ohio. The field staff conducts compliance and safety check surveys of Ohio’s Medicaid consumers receiving Medicaid program services administered by other state agencies, and Medicaid-contracted managed care plans. Many of these compliance and safety check surveys occur in the consumer’s home.


Responsibilities


As the Compliance and Safety Check Supervisor in the Office of Health Innovation & Quality, Ohio Department of Medicaid (ODM), your responsibilities will include

  • Standard supervisory activities establish unit goals, assign work, provide direction, review work, provide feedback, encourage staff development, etc.
  • Monitoring and evaluating performance
  • Conducting staff meetings
  • Approving/denying leave requests
  • Recommending applicants to hire
  • Recommending discipline
  • Traveling to monitor the staff/unit’s review process and ensure timely completion of assignments
  • Collaborating with other Ohio Department of Medicaid (ODM) units, sections, and bureaus to develop and coordinate compliance and safety reviews for ODM waivers, state plan and other quality initiatives.
  • Serving on various committees relevant to ODM’s oversight activities and quality initiatives

Completion of graduate core program in business, management or public administration, public health, health administration, social or behavioral science or public finance; 12 mos. exp. in the delivery of a health services program or health services project management (e.g., health care data analysis, health services contract management, health care market & financial expertise; health services program communication; health services budget development, HMO & hospital rate development, health services eligibility, health services data base analysis).


Or 12 months experience as a Medicaid Health Systems Specialist, 65293.


Note: education & experience is to be commensurate with approved position description on file.

  • Or equivalent of Minimum Class Qualifications for Employment noted above.

Primary Location


United States of America-OHIO-Franklin County-Columbus


Work Locations


Lazarus 5


Organization


Ohio Department of Medicaid


Classified Indicator


Classified


Bargaining Unit / Exempt


Exempt


Schedule


Full-time


Work Hours


8:00AM – 5:00PM


Compensation


$33.69/hour


Unposting Date


Ongoing


Job Function


Nursing


Job Level


Manager / Supervisor


Agency Contact Information


HumanResources@medicaid.ohio.gov

 
 

 
 

Clipped from: https://www.linkedin.com/jobs/view/compliance-and-safety-check-supervisor-medicaid-health-systems-administrator-1-at-ohio-department-of-medicaid-2732482608/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Social Science Research Analyst. | Centers for Medicare & Medicaid Services

 
 

 

  • Develops and conducts program and policy analyses to identify and understand the needs and preferences of HHS health and human services programs and the populations they serve.
  • Designs and conducts research and studies to measure the quality of care received by beneficiaries in Medicare/Medicaid certified programs for all provider and suppliers
  • Designs and conducts research on the impact, cost, and effectiveness of the Survey and Certification Program including acute care providers, continuing care providers, and long-term care providers.
  • Counsel and mentor the development of colleagues.

Travel Required


25% or less – You may be expected to travel for this position.


Supervisory status


No


Promotion Potential


13

  • Job family (Series)
  • Requirements

Conditions of Employment

  • You must be a U.S. Citizen or National to apply for this position.
  • You will be subject to a background and suitability investigation.
  • Time-in-Grade restrictions apply.

Qualifications


ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT.


Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration.


In order to qualify for the GS-13, you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-12 grade level in the Federal government, obtained in either the private or public sector, to include: (1) Utilization of analytical software (SAS, STATA, SPSS, or R); (2) Utilization of social science methodologies such as linear regression, logistic regression, natural language processing, survival analysis, or other multivariate techniques (i.e., cluster analysis, factor analysis and multidimensional scaling) to analyze data; AND (3) Conducting statistical analyses of large datasets (e.g., Census data, health care claims data, large clinical databases, and/or other population databases).


Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.


Time-in-Grade: To be eligible, current or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying.


Education


Education Requirement: In addition to meeting the qualification requirements, all candidates must have the following educational requirements:


Degree: behavioral or social science; or related disciplines appropriate to the position. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION)


or


Combination of education and experience that provided the applicant with knowledge of one or more of the behavioral or social sciences equivalent to a major in the field. (TRANSCRIPT REQUIRED AT TIME OF APPLICATION)


or


Four years of appropriate experience that demonstrated that the applicant has acquired knowledge of one or more of the behavioral or social sciences equivalent to a major in the field.


TRANSCRIPTS are required to verify satisfactory completion of the educational requirement listed above. Please see “Required Documents” section below for what documentation is required at the time of application.


Click The Following Link To View The Occupational Questionnaire


Additional information


Bargaining Unit Position: Yes


Tour of Duty: Flexible


Recruitment/Relocation Incentive: Not Authorized


Financial Disclosure: Not Required


Additional Forms REQUIRED Prior To Appointment

  • Optional Form 306, Declaration of Federal Employment and the Background/Suitability Investigation – A background and suitability investigation will be required for all selectees. Appointment will be subject to the successful completion of the investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a reinvestigation or supplemental investigation may be required at a later time. If selected, the Optional Form 306 will be required prior to final job offer.
  • Form I-9, Employment Verification and the Electronic Eligibility Verification Program – CMS participates in the Electronic Employment Eligibility Verification Program (E-Verify). E-Verify helps employers determine employment eligibility of new hires and the validity of their Social Security numbers. If selected, the Form I-9 will be required at the time of in-processing.
  • Standard Form 61, Appointment Affidavits – If selected, the Standard Form 61 will be required at the time of in-processing.

The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy.


Salary Information (per Year)

  • Atlanta, GA: $97,078 – $126,202
  • Boston, MA: $102,601 – $133,382
  • Chicago, IL: $102,188 – $132,845
  • Dallas, TX: $99,319 – $129,116
  • Denver, CO: $101,028 – $131,337
  • Kansas City, MO: $93,081 – $121,006
  • New York, NY: $106,471 – $138,413
  • Philadelphia, PA: $100,161 – $130,211
  • San Francisco, CA: $112,400 – $146,120
  • Seattle, WA: $100,940 – $131,223
  • Woodlawn, MD: $103,690 – $134,798

Duty station and salary will be determined upon selection.


If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an


How You Will Be Evaluated


You will be evaluated for this job based on how well you meet the qualifications above.


Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with any interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.


Once the announcement has closed, your online application, resume, transcripts and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.


Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):

  • Analysis
  • Attention to Detail
  • Flexibility
  • Integrity/Honesty
  • Interpersonal Skills
  • Learning
  • Oral Communication
  • Research
  • Self-Management
  • Stress Tolerance
  • Teamwork
  • Writing

Background checks and security clearance


Security clearance


Drug test required


No


Position sensitivity and risk


Trust determination process

  • Required Documents

The Following Documents Are REQUIRED

  • Resume showing relevant experience; cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates (mm/yyyy) of each employment along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips visit:
  • CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement.
  • College Transcripts. Since this position requires specific education, you must submit a transcript attesting to your possession of the required education. You may submit an unofficial transcript or a list of college courses completed indicating course titles, credit hours, and grades received. An official transcript is required if you are selected for the position. If selected, you must provide an original document before the final job offer may be extended. If you do not submit a transcript indicating your possession of the required education, you will not be considered for this position.

College Transcripts and Foreign Education: Applicants who have completed part or all of their education outside of the U.S. must have their foreign education evaluated by an accredited organization to ensure that the foreign education is comparable to education received in accredited educational institutions in the U.S. For a listing of services that can perform this evaluation, visit the


If you are applying for a position for which a state license is issued (e.g., physician, engineer, attorney) possession of a valid and current U.S. professional license by a graduate of a foreign professional school or program is sufficient proof that the foreign education has been determined to be equivalent to the requisite U.S. professional education in that occupational field.


PLEASE NOTE: A complete application package includes the online application, resume, transcripts and CMS required documents. Please carefully review the full job announcement to include the “Required Documents” and “How to Apply” sections. Failure to submit the online application, resume, transcripts and CMS required documents, will result in you not being considered for employment.


If you are relying on your education to meet qualification requirements:


Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from


Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

  • Benefits

A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.


Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.

  • How to Apply

Your complete application package, as described in the “Required Documents” section, must be received by 11:59 PM ET on 09/29/2021 to receive consideration.


IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.


Please Ensure EACH Work History Includes ALL Of The Following Information


We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes.

  • Official Position Title (include series and grade if Federal job)
  • Duties (be specific in describing your duties)
  • Employer’s name and address
  • Supervisor name and phone number
  • Start and end dates including month and year (e.g. June 2007 to April 2008)
  • Full-time or part-time status (include hours worked per week)
  • Salary

Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.

  • To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
  • Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
  • After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
  • You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.

To verify the status of your application, log into your USAJOBS account (


This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to Lindsey.Nedd@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.


Commissioned Corps Officers Officers (including Commissioned Corps applicants that are professionally boarded) who are interested in applying for this position must send their professional resume (not PHS Curriculum Vitae) and cover letter to


Agency contact information


Lindsey Nedd


Email


Address


Center for Clinical Standards and Quality


7500 Security Blvd


Woodlawn, MD 21244


US


Next steps


Once your online application is submitted, you will receive a confirmation notification by email. Your application will be evaluated to determine your eligibility and qualifications for the position. After the evaluation is complete, you will receive another email notification regarding the status of your application.


Within 30 business days of the closing date,09/29/2021, you may check your status online by logging into your USAJOBS account (

  • Fair & Transparent

The Federal hiring process is setup to be fair and transparent. Please read the following guidance.


Equal Employment Opportunity Policy


The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.


Reasonable Accommodation Policy


Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application process should follow the instructions in the job opportunity announcement. For any part of the remaining hiring process, applicants should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.


A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.


Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when:

  • An applicant with a disability needs an accommodation to have an equal opportunity to apply for a job.
  • An employee with a disability needs an accommodation to perform the essential job duties or to gain access to the workplace.
  • An employee with a disability needs an accommodation to receive equal access to benefits, such as details, training, and office-sponsored events.

You can request a reasonable accommodation at any time during the application or hiring process or while on the job. Requests are considered on a case-by-case basis.


Learn more about


Legal and regulatory guidance


This job originated on

 
 

Clipped from: https://www.linkedin.com/jobs/view/social-science-research-analyst-at-centers-for-medicare-medicaid-services-2738594372/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Tufts Medical Center Community Health Worker

 
 

 
 

Company Description

It takes a lot of very smart, hard-working and talented people to provide the level of care that we give to our patients. Tufts Medical Center is an internationally respected academic medical center and we pride ourselves not only on the sophistication of the care we deliver, but the compassionate way in which we provide it. And that starts with our employees.

Job Description

The Community Health Worker (CHW) delivers culturally-competent services to help patients navigate and access community services, other resources and adopt health behaviors. The CHW assists with care coordination tasks such as setting up appointments and/or transportation; providing basic patient education; assistance with navigating medical and behavioral health systems; and facilitating communications with providers and other care team members. They help patients’ self-management by identifying their non-medical needs, assisting with care plan development, and working towards patient-centered goals.

PRINCIPAL DUTIES AND ESSENTIAL FUNCTIONS:

Key responsibilities:

  • Supports the care team by communicating with patients to follow up after appointments, to confirm materials were received, to help coordinate non-medical services, and to obtain needed medical supplies and devices
  • Coordinates referrals to community partners, services and resources, researches resources, maintains resource databases, and establishes and maintains relationships with local/community institutions
  • Acts as a patient advocate and liaison among internal and external providers, and community resources to integrate complex services and identify gaps and challenges in care and communication
  • Conducts telephonic and face to face patient outreach to activate patients to become involved in managing their health, and collaborating with the healthcare team to develop patient-centered care plans and patient goals
  • Identifies the need for services based on barriers (e.g. language, literacy, and cultural preferences)
  • Provides patient-centered health promotion, coaching on self-management and education
  • Maintains collaborative, team relationships with peers and colleagues in order to effectively contribute to the working group’s achievement of goals, and tactics to meet the overall organizational goals
  • Community outreach, such as home visits and health screenings will also be required.

Qualifications

JOB KNOWLEDGE AND SKILLS

  • Lives in and/or has familiarity with the target community and feels connected to that community
  • Demonstrates ability to work well with people of various ages, backgrounds, ethnicities, cultures and life experiences
  • Experience working in a multi-cultural setting
  • Experience working in a community-based setting and clinically-based settings
  • Excellent interpersonal and communication skills telephonically, as well as face to face
  • Strong customer services skills
  • Detail oriented, with strong organizational skills and multi-tasking abilities
  • Ability to work independently with minimal supervision and as part of a team
  • Knowledge of medical terminology strongly preferred
  • Very strong working knowledge and proficiency with technology and business software (Microsoft Office)
  • Fluency in second language preferred but not required

EDUCATION AND EXPERIENCE:

  • Current High School diploma or GED required. College degree preferred in related areas such as health sciences, health care, customer services, administration etc.
  • 1 – 3 years of experience in healthcare related field such as hospital, health center, home health provider, community based agency. Customer service a plus

LICENSES

  • Not applicable at this time

WORKING CONDITIONS/PHYSICAL DEMANDS:

  • Work is in a fast paced office-based setting.
  • Reliable transportation is necessary. The NEQCA office is located in Braintree with travel to Local Care Organizations and community hospitals intermittently.
  • Work sometimes includes meetings outside of normal business hours

Additional Information

All your information will be kept confidential according to EEO guidelines.

AMERICANS WITH DISABILITIES STATEMENT:

Must be able to perform all essential functions of this position with reasonable accommodation if disabled.

The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed, as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. Tufts Medical Center reserves the right to modify position duties at any time, to reflect process improvements and business necessity.

COVID-19 POLICY:

Please note that effective October 1, 2021, as a condition of employment at Tufts Medical Center, all employees and new hires must have received their complete dose of the COVID-19 vaccine, unless they have been granted an exemption.  

 
 

Clipped from: https://jobs.smartrecruiters.com/TuftsMedicalCenter1/743999776367731-community-health-worker-medicaid-aco?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Healthcare Informatics Analyst – Two Positions (Health Services Policy Analyst) | Ohio Department of Medicaid

 
 

The Ohio Department of Medicaid (ODM) is committed to improving the health of Ohioans and strengthening communities and families through quality care. In 2020, ODM introduced a new vision for Ohio’s Medicaid program — one that strengthens Ohio’s future and ensures everyone has the chance to live life to its full potential.


Today, more than 90 percent of Ohio Medicaid members are supported by managed care organizations. During the year ahead, ODM will begin implementing a new vision for care; focusing on the individual, a strong partnership among MCOs and the department, and supporting specialization in addressing critical needs.


A program that puts the individual first


They Are


Adopting Governor DeWine’s philosophy of service to Ohioans, ODM embarked on an aggressive effort to redesign its managed care program. The goal is to provide more personal, holistic care and supports for millions of Ohioans served by Medicaid. Listening to feedback from more than 1,100 individuals and organizations we identified five procurement goals that would put the individual front and center of Medicaid’s program and policy decisions.

  • Emphasize a personalized care experience
  • Improve care for children and adults with complex behavioral health needs
  • Improve wellness and health outcomes
  • Support providers in better patient care
  • Increase program transparency and accountability

UNLESS REQUIRED BY LEGISLATION OR UNION CONTRACT, STARTING SALARY WILL BE SET AT STEP 1 OF THE PAY RANGE


Office: Data Governance & Analysis


Classification: Health Services Policy Analyst (PN 20037738 & 20099221)


Job Overview


The Ohio Department of Medicaid (ODM) is seeking to fill two analyst positions in its Data Governance & Analysis team. These positions will support the ongoing procurement efforts of the agency as it transforms healthcare delivery in the state into a person-centered enterprise. The two positions available are:


Data Informatics Analyst (PN 20037738) –

  • Critical to developing best practices that drive improved health outcomes across the state
  • Assist in communicating data and metrics to a variety of stakeholders as part of our ODM’s Dashboarding Analytics team
  • Attend meetings to assist in the development of tools, metrics, dashboards, and models to aid policy decision-making
  • Conduct literature reviews to identify and implement best practices in program oversight
  • Prepare reports related to state and federal requirements
  • Familiarity and experience with healthcare data is preferred, but not required
  • Experience with data visualization is strongly preferred

Managed Care Informatics Analyst (PN 20099221)

  • Heavily involved in the monitoring and reporting related to the newly contracted Medicaid managed care plans
  • Work on an interdisciplinary team on topics related to population health measurement, health equity, quality improvement, and performance metric design
  • Assist in the assessment of several unique elements of the ODM managed care contract, including community investment requirements and transparency initiatives
  • Attend meetings to assist in the development of tools, metrics, dashboards, and models to aid policy decision-making
  • Respond to requests for data from internal and external stakeholders
  • Conduct literature reviews to identify and implement best practices in program oversight
  • Prepare reports related to state and federal requirements

The ideal candidates will be familiar with relational databases and demonstrate experience with data analysis. They will be self-directed and enthusiastic about conducting research to enhance program evaluation and oversight. Those from a variety of backgrounds including but not limited to public health, public administration, business administration, information technology, data analytics, sociology, and political science are encouraged to apply.


Completion of graduate core coursework in health services administration, mathematics, statistics, actuarial science, public administration, allied health sciences, nursing, economics or comparable field; 12 mos. trg. or 12 mos. exp. in research methodology, measurement & testing, analysis of variance & survey sampling; 6 mos. trg. or 6 mos. exp. in use of computer programs/applications used for spreadsheets, statistical analysis & graphics presentation & word processing; 1 course or 3 mos. exp. in multiple regression or multivariate analysis.

  • Or completion of undergraduate core coursework & 12 mos. exp. in one of following: health services administration, mathematics, statistics, actuarial science, public administration, allied health sciences, nursing, economics, public health, or comparable field; 12 mos. trg. or 12 mos. exp. in research methodology, measurement & testing, analysis of variance & survey sampling; 6 mos. trg. or 6 mos. exp. in use of computer programs/applications used for spreadsheets, statistical analysis & graphics presentation & word processing; 1 course or 3 mos. exp. in multiple regression or multivariate analysis.
  • Or equivalent of Minimum Class Qualifications For Employment noted above.

Primary Location


United States of America-OHIO-Franklin County-Columbus


Work Locations


Lazarus 5


Organization


Ohio Department of Medicaid


Classified Indicator


Classified


Bargaining Unit / Exempt


Bargaining Unit


Schedule


Full-time


Work Hours


8:00AM – 5:00PM


Compensation


$30.03/hour


Unposting Date


Oct 13, 2021, 10:59:00 PM


Job Function


Statistics/Mathematics


Job Level


Individual Contributor


Agency Contact Information


HumanResources@medicaid.ohio.gov

 
 

Clipped from: https://www.linkedin.com/jobs/view/healthcare-informatics-analyst-two-positions-health-services-policy-analyst-at-ohio-department-of-medicaid-2732429650/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on

Program Analyst. | Centers for Medicare & Medicaid Services

 

 

  • Analyst on cross-functional matrix teams, such as program evaluation and assessment; continuous quality improvement; or the planning implementation.
  • Research complex administrative regulations and policies, and formulate suggested courses of action for leadership decision based on the findings.
  • Make presentations and conducts training in changes to regulation, policies and procedures.
  • Compile and analyze data which address issues such as workforce and productivity; management controls, and implementation plans in response to Executive Orders or laws.

Travel Required


Occasional travel – You may be expected to travel 10% for this position.


Supervisory status


No


Promotion Potential


13

  • Job family (Series)

Similar jobs

  • Requirements

Conditions of Employment

  • You must be a U.S. Citizen or National to apply for this position.
  • You will be subject to a background and suitability investigation.
  • Time-in-Grade restrictions apply.

Qualifications


ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT.


Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration.


In order to qualify for the GS-13, you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-12 grade level in the Federal government, obtained in either the private or public sector, to include: (1) using data analytics, including interactive visual analytics such as dashboards, to recommend improvements that support the achievement of the organization’s strategic agenda; and (2) working across various offices to conduct data mining and data collection activities, using quantitative or qualitative methods, to develop solutions and resolve inefficiencies in policies and program outcomes; and (3) facilitating discussions and presenting data to various levels of staff, including senior leadership, through a variety of automated tools and techniques, e.g., Tableau, Quicksight, R, Python, to drive decisions and outcomes for programs across the enterprise.


Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.


Time-in-Grade: To be eligible, current or former Federal employees and current or former Federal employees applying under the VEOA eligibility who hold or have held a permanent General Schedule position in the previous year must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying.


Click The Following Link To View The Occupational Questionnaire


Education


This job does not have an education qualification requirement.


Additional information


Bargaining Unit Position: No 8888


Tour of Duty: Flexible


Recruitment/Relocation Incentive: Not Authorized


Financial Disclosure: Required


Full-Time Telework Program for CMS Employees: CMS employees currently participating in 100% Full-Time Telework Program may be eligible to remain in the program. If an employee in this program is selected, the pay will be set in accordance with the locality pay for the applicable duty station. The listed salary range reflects the locality pay assigned to the duty location(s) listed in the vacancy announcement. For more information about pay based on locality, please visit the


Additional Forms REQUIRED Prior To Appointment

  • Optional Form 306, Declaration of Federal Employment and the Background/Suitability Investigation – A background and suitability investigation will be required for all selectees. Appointment will be subject to the successful completion of the investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a reinvestigation or supplemental investigation may be required at a later time. If selected, the Optional Form 306 will be required prior to final job offer.
  • Form I-9, Employment Verification and the Electronic Eligibility Verification Program – CMS participates in the Electronic Employment Eligibility Verification Program (E-Verify). E-Verify helps employers determine employment eligibility of new hires and the validity of their Social Security numbers. If selected, the Form I-9 will be required at the time of in-processing.
  • Standard Form 61, Appointment Affidavits – If selected, the Standard Form 61 will be required at the time of in-processing.

The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy.


If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an


How You Will Be Evaluated


You will be evaluated for this job based on how well you meet the qualifications above.


Additional selections may be made for similar positions across the Department of Health and Human Services (HHS) within the local commuting area(s) of the location identified in this announcement. By applying, you agree to have your application shared with any interested selecting official(s) at HHS. Clearance of CTAP/ICTAP will be applied for similar positions across HHS.


Once the announcement has closed, your online application, resume, transcripts and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.


Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):

  • Oral Communication
  • Planning and Evaluating
  • Project Management
  • Written Communication

Background checks and security clearance


Security clearance


Drug test required


No


Position sensitivity and risk


Trust determination process

  • Required Documents

The Following Documents Are REQUIRED

  • Resume showing relevant experience; cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates (mm/yyyy) of each employment along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips visit:
  • CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Required documents may be necessary to be considered for this vacancy announcement.

PLEASE NOTE: A complete application package includes the online application, resume, transcripts and CMS required documents. Please carefully review the full job announcement to include the “Required Documents” and “How to Apply” sections. Failure to submit the online application, resume, transcripts and CMS required documents, will result in you not being considered for employment.

  • Benefits

A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.


Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.

  • How to Apply

Your complete application package, as described in the “Required Documents” section, must be received by 11:59 PM ET on 09/30/2021 to receive consideration.


IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.


Please Ensure EACH Work History Includes ALL Of The Following Information


We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes.

  • Official Position Title (include series and grade if Federal job)
  • Duties (be specific in describing your duties)
  • Employer’s name and address
  • Supervisor name and phone number
  • Start and end dates including month and year (e.g. June 2007 to April 2008)
  • Full-time or part-time status (include hours worked per week)
  • Salary

Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.

  • To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
  • Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
  • After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
  • You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.

To verify the status of your application, log into your USAJOBS account (


This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to Kristina.spirko@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.


Commissioned Corps Officers Commissioned Corps Officers (including Commissioned Corps applicants that are professionally boarded) who are interested in applying for this position must send their professional resume (not PHS Curriculum Vitae) and cover letter to


Agency contact information


Kristina Spirko


Email


Address


Office of Strategy, Performance and Results


7500 Security Blvd


Woodlawn, MD 21244


US


Next steps


Once your online application is submitted, you will receive a confirmation notification by email. Your application will be evaluated to determine your eligibility and qualifications for the position. After the evaluation is complete, you will receive another email notification regarding the status of your application.


Within 30 business days of the closing date,09/30/2021, you may check your status online by logging into your USAJOBS account (

  • Fair & Transparent

The Federal hiring process is setup to be fair and transparent. Please read the following guidance.


Equal Employment Opportunity Policy


The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.


Reasonable Accommodation Policy


Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application process should follow the instructions in the job opportunity announcement. For any part of the remaining hiring process, applicants should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.


A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.


Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when:

  • An applicant with a disability needs an accommodation to have an equal opportunity to apply for a job.
  • An employee with a disability needs an accommodation to perform the essential job duties or to gain access to the workplace.
  • An employee with a disability needs an accommodation to receive equal access to benefits, such as details, training, and office-sponsored events.

You can request a reasonable accommodation at any time during the application or hiring process or while on the job. Requests are considered on a case-by-case basis.


Learn more about


Legal and regulatory guidance


This job originated on

 
 

Clipped from: https://www.linkedin.com/jobs/view/program-analyst-at-centers-for-medicare-medicaid-services-2738594485/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on

Health Insurance Specialist. | Centers for Medicare & Medicaid Services

 
 

Summary


This position is located in the Department of Health & Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation(CMMI), State Innovations Group (SIG).


As a Health Insurance Specialist, GS-0107-13, you will perform program policy work related to national health insurance programs, such as Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and Marketplace Exchange/private health insurance.


Responsibilities

  • Identify and propose modifications to policies to reflect changes or trends in the health care industry, program objectives and the needs of beneficiaries.
  • Conduct analysis of policy issues and topics by researching background information, the origin of laws, and the intended impact in order to make effective policy recommendations.
  • Act as an Agency representative and contribute to discussions and planning sessions on program policy developments.
  • Prepare all forms of written correspondence regarding program policy related activities and Medicaid issues to the public, Congressional staff, industry contacts, and State representatives.
  • Develop regulations, policy statements, and other program guidance relating to national health insurance programs.

Travel Required


Occasional travel – You may be expected to travel up to 5% for this position.


Supervisory status


No


Promotion Potential


13

  • Job family (Series)
  • Requirements

Conditions of Employment

  • You must be a U.S. Citizen or National to apply for this position.
  • You will be subject to a background and suitability investigation.
  • Time-in-Grade restrictions apply.

Qualifications


ALL QUALIFICATION REQUIREMENTS MUST BE MET WITHIN 30 DAYS OF THE CLOSING DATE OF THIS ANNOUNCEMENT.


Your resume must include detailed information as it relates to the responsibilities and specialized experience for this position. Evidence of copying and pasting directly from the vacancy announcement without clearly documenting supplemental information to describe your experience will result in an ineligible rating. This will prevent you from receiving further consideration.


In order to qualify for the GS-13 , you must meet the following: You must demonstrate in your resume at least one year (52 weeks) of qualifying specialized experience equivalent to the GS-12 grade level in the Federal government, obtained in either the private or public sector, to include:

  • Conducting analysis of national health insurance program policy issues in order to propose policy modifications; AND
  • Implementing analytical or evaluative methods to improve health insurance policies or operations; AND
  • Presenting recommendations and conclusions based on analysis and evaluation of health insurance programs that describe feasible options and/or the consequences.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community, student, social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.


Time-in-Grade: To be eligible, current Federal employees must have served at least 52 weeks (one year) at the next lower grade level from the position/grade level(s) to which they are applying.


Click The Following Link To View The Occupational Questionnaire


Education


This job does not have an education qualification requirement.


Additional information


Bargaining Unit Position: Yes


Tour of Duty: Flexible


Recruitment/Relocation Incentive: Not Authorized


Financial Disclosure: Not Required


CMS employees currently participating in 100% Full-Time Telework Program may be eligible to remain in the program. If an employee in this program is selected, the pay will be set in accordance with the locality pay for the applicable duty station. The listed salary range reflects the locality pay assigned to the duty location(s) listed in the vacancy announcement. For more information about pay based on locality, please visit the


The Interagency Career Transition Assistance Plan (ICTAP) and Career Transition Assistance Plan (CTAP) provide eligible displaced federal employees with selection priority over other candidates for competitive service vacancies. To be qualified you must submit the required documentation and be rated well-qualified for this vacancy.


Additional Forms REQUIRED Prior To Appointment

  • Optional Form 306, Declaration of Federal Employment and the Background/Suitability Investigation – A background and suitability investigation will be required for all selectees. Appointment will be subject to the successful completion of the investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a reinvestigation or supplemental investigation may be required at a later time. If selected, the Optional Form 306 will be required prior to final job offer.
  • Form I-9, Employment Verification and the Electronic Eligibility Verification Program – CMS participates in the Electronic Employment Eligibility Verification Program (E-Verify). E-Verify helps employers determine employment eligibility of new hires and the validity of their Social Security numbers. If selected, the Form I-9 will be required at the time of in-processing.
  • Standard Form 61, Appointment Affidavits – If selected, the Standard Form 61 will be required at the time of in-processing.

Additional selections may be made from this announcement for similar positions within CMS in the same geographical location. For Central Office vacancies, the “same geographical location” includes Baltimore, Maryland; Bethesda, Maryland; and Washington, D.C.


If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an


How You Will Be Evaluated


You will be evaluated for this job based on how well you meet the qualifications above.


Once the announcement has closed, your online application, resume, and CMS required documents will be used to determine if you meet eligibility and qualification requirements listed on this announcement. If you are found to be among the top qualified candidates, you will be referred to the selecting official for employment consideration. Please follow all instructions carefully. Errors or omissions may affect your rating.


Your qualifications will be evaluated on the following competencies (knowledge, skills, abilities and other characteristics):

  • Health Insurance
  • Oral Communication
  • Policy Analysis
  • Written Communication

This position is being filled through a temporary promotion that may not exceed one year. Only in rare instances are extensions beyond one year granted. Management may end this opportunity at any time, and in such cases, the employee is returned to his/her previous position or to another position of equivalent grade and pay. In addition, this opportunity may be made permanent at any time without further competition.


Background checks and security clearance


Security clearance


Drug test required


No


Position sensitivity and risk


Trust determination process

  • Required Documents

The Following Documents Are REQUIRED

  • Resume showing relevant experience; cover letter optional. Your resume must indicate your citizenship and if you are registered for Selective Service if you are a male born after 12/31/59. Your resume must also list your work experience and education (if applicable) including the start and end dates (mm/yyyy) of each employment along with the number of hours worked per week. For work in the Federal service, you must include the series and grade level for the position(s). Your resume will be used to validate your responses to the assessment tool(s). For resume and application tips visit:
  • CMS Required Documents (e.g., SF-50, DD-214, SF-15, etc.). Current CMS employees are REQUIRED to submit a copy of their most recent Notification of Personnel Action (SF-50) at the time of application. Additional documents may also be required to be considered for this vacancy announcement.

PLEASE NOTE: A complete application package includes the online application, resume, and CMS required documents. Please carefully review the full job announcement to include the “Required Documents” and “How to Apply” sections. Failure to submit the online application, resume and CMS required documents, will result in you not being considered for employment.

  • Benefits

A career with the U.S. Government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.


Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time, or intermittent. Contact the hiring agency for more information on the specific benefits offered.

  • How to Apply

To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the “Required Documents” section below. A complete application package (to include resume, occupational questionnaire, and other applicable supporting documents) must be received by 11:59 PM ET on 09/29/2021 to receive consideration.


IN DESCRIBING YOUR WORK EXPERIENCE AND/OR EDUCATION, PLEASE BE CLEAR AND SPECIFIC REGARDING YOUR EXPERIENCE OR EDUCATION.


Please Ensure EACH Work History Includes ALL Of The Following Information


We strongly encourage applicants to utilize the USAJOBS resume builder in the creation of resumes.

  • Official Position Title (include series and grade if Federal job)
  • Duties (be specific in describing your duties)
  • Employer’s name and address
  • Supervisor name and phone number
  • Start and end dates including month and year (e.g. June 2007 to April 2008)
  • Full-time or part-time status (include hours worked per week)
  • Salary

Determining length of general or specialized experience is dependent on the above information and failure to provide ALL of this information WILL result in a finding of ineligible.

  • To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application.
  • Follow the prompts to select your resume and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
  • After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
  • You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application.

To verify the status of your application, log into your USAJOBS account (


This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please send an email to Rhonda.Gray@cms.hhs.gov. The decision to grant reasonable accommodation will be made on a case-by-case basis.


Commissioned Corps Officers (including Commissioned Corps applicants that are professionally boarded) who are interested in applying for this position must send their professional resume (not PHS Curriculum Vitae) and cover letter to


Agency contact information


Rhonda Gray


Email


Address


Center for Medicare and Medicaid Innovation


7500 Security Blvd


Woodlawn, MD 21244


US


Next steps


Once your online application is submitted, you will receive a confirmation notification by email. Your application will be evaluated to determine your eligibility and qualifications for the position. After the evaluation is complete, you will receive another email notification regarding the status of your application.


Within 30 business days of the closing date,09/29/2021, you may check your status online by logging into your USAJOBS account (

  • Fair & Transparent

The Federal hiring process is setup to be fair and transparent. Please read the following guidance.


Equal Employment Opportunity Policy


The United States Government does not discriminate in employment on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, retaliation, parental status, military service, or other non-merit factor.


Reasonable Accommodation Policy


Federal agencies must provide reasonable accommodation to applicants with disabilities where appropriate. Applicants requiring reasonable accommodation for any part of the application process should follow the instructions in the job opportunity announcement. For any part of the remaining hiring process, applicants should contact the hiring agency directly. Determinations on requests for reasonable accommodation will be made on a case-by-case basis.


A reasonable accommodation is any change to a job, the work environment, or the way things are usually done that enables an individual with a disability to apply for a job, perform job duties or receive equal access to job benefits.


Under the Rehabilitation Act of 1973, federal agencies must provide reasonable accommodations when:

Posted on

Medicaid Helpdesk Analyst/PM | innoSoul, Inc.

 
 

Job ID NC-653383 (97890607)Medicaid Helpdesk AnalystPM (ServiceNow certified) with systemsnetworksinterfaces, MS ProjectAccess, Adobe, data analytics, JIRA, TestingALM, incidentrelease management, MITA experience Location Raleigh NC (NCDHHS) Duration 12+ months Interview Webcam Interview Only Skills


Knowledge of enterprise IT systems, networks, and system interfaces Required 3 Years Ability to manage multiple projectspriorities and function in a fast-paced constantly changing, deadline driven environment Required 3 Years Proficient use of Microsoft Project, Word, Excel, PowerPoint, Access, Adobe software etc. Required 3 Years Prior experience work with data analytics or programming Required 3 Years Experience in IT system problem determination, resolution Required 3 Years Understanding of Software Development Lifecycle (SDLC) concepts and process Required 3 Years Knowledge of and experience with IT Service Management best practices and principles Required 3 Years Service Now certification and or hands on system administrator experience with the product Highly desired 3 Years JIRA knowledge or experience and or extensive knowledge and expertise with the product Highly desired 3 Years Knowledge of and experience with Test Management tool products such as the ALM suite Highly desired 3 Years Knowledge of Medicaid Program or Health Care Technology Highly desired 3 Years. NC Department of Health and Human Services (DHHS) Information Technology Division (ITD) seeks an Systems Technical Specialist (STS) to join the MES Project. Technical and Business Analyst expertise are key. Extensive ServiceNow knowledge desired. The Systems Technical Specialist (STS) provides multi-vendor systems implementation support for deployment and integration efforts of enterprise IT systems supporting Medicaid IT Operations. The STS works under the direction of the System Integration Engineer (SIE) who is the technical resource to address problems of systems integration and compatibility across multiple platforms. The STS supports the SIE and the lead Project Manager (PM) in conducting business reviews, documenting current systems, and developing recommendations of how to proceed with integration of applications. This role contributes to the planning, implementation and operations of the enterprise system. The STS is directly responsible for various components of IT Service Management (ITSM) inclusive of incident, change, and release management due diligence activities. Other duties will be assigned by management. The successful candidate will have a good understanding of SDLC, software applications, system integration, and the ability to manage priorities with varying levels of complexity. Knowledge, Skills and Abilities


Competencies bull Understanding of IT processes such as, applications development, testing, deployment, operations, documentation, standards, and best practices bull Understanding of ITSM processes bull In-Depth ability to solve problems and rapidly grasp technology concepts bull Understanding of MITA bullKnowledge of applicable business information systems, business system analysis techniques and testing methodologies. Additional duties for this role will require the ability to bullIdentify and document business processes and data flows bullConduct detailed analysis between the business requirements bullDocument detailed business requirements related to the business processes and tracking requirements traceability bullDocument the gap analysis, and assist with development of project artifacts including test plans. bullDeveloping test scenarios and test cases and execution of user acceptance testing bullUtilize Microsoft Office Suite (MS Word, EXCEL, PowerPoint, Visio) and Microsoft Project bullUtilize ITSM tools and software such as JIRA, HP ALM, and Service Now 653383 Skill Matrix.docx httpinnosoul.comwp-contentuploads202106653383-Skill-Matrix.docx

 
 

Clipped from: https://www.linkedin.com/jobs/view/medicaid-helpdesk-analyst-pm-at-innosoul-inc-2739295893/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Member Enrollment Specialist/ Medicaid- Centene

 
 

You could be the one who changes everything for our 25 million members. 
Centene is transforming the health of our communities, one person at a time. 
As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Position Purpose:

  Maintain day to day enrollment and pre-member functions and respond to questions related to enrollment.

  • Respond to internal/external inquiries regarding enrollment
  • Work members’ transaction requests in the customer relationship management system
  • Generate and coordinate distribution of enrollment kits and identification cards
  • Medicaid Line of Business
  • Research member enrollment for issue resolution
  • Update enrollment information, including demographic/contact information
  • Place outbound calls to collect premium payments for pre-enrolled members
  • Basic Excel Skills
  • Potential for overtime

Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development

Education/Experience:

High school diploma or equivalent. 0+ years of transaction processing, data reconciliation, membership records, or related managed care/healthcare experience.


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

 
 

Clipped from: https://jobs.centene.com/us/en/job/1245502/Member-Enrollment-Specialist-Medicaid?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic