Posted on

Senior Business Analyst – Medicaid Enterprise System – Indianapolis, United States

 
 

Found in: Whatjobs US Premium

Description:

Overview Public Consulting Group, Inc.

(PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives.

Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide.

PCG’s Technology Consulting practice offers a full spectrum of quality Information Technology (IT) services to help state and local government agencies at every stage of the IT life cycle.

Through its specialized IT services, PCG’s Technology Consulting team finds cost-effective ways to help agency partners deliver successful IT systems that enhance the lives of the user base.

To learn more, visit Responsibilities Specific Responsibilities:
 

  • Serve as business analyst and subject matter expert on project engagements.
  • Identify and recommend client business process improvements.
  • Facilitate and manage software development life cycle activities, such as requirements sessions.
  • Coordinate the user acceptance testing process.
  • Communicate and/or translate business challenges to IT and assist in developing solutions.
  • Serve as liaison between various stakeholder groups and other third-party vendors.
  • Create artifacts and formal deliverables relative to project initiatives.
  • Contribute to project work plans, and other formal project management deliverables relative to project initiatives.
  • Prepare other written reports and materials for clients.
  • Identifies, documents, resolves and/or escalates issues to the appropriate level

Qualifications Required Skills/Experience:
 

  • Self-directed and comfortable working directly with clients to determine needs, clarify tasks and expectations, and present work products and findings
  • 5+ years of business analysis experience
  • 5+ years of MES (Medicaid) experience
  • Bachelor’s degree from an accredited college/university
  • Knowledge and experienced in business requirements validation and test case creation and review (e.g., verification of requirements coverage)
  • Demonstrated ability to work cooperatively within and among teams Desired Skills/Experience:
  • Experience providing IV services or similar oversight activities (e.g., QA).
  • Completed Project Management Institute (PMI) Project Management Professional (PMP) certification, or similar Project Management certification.
  • Experience in Medicaid program application, eligibility, and enrollment operations and policy #D-PCG #LI-AH1 EEO Statement Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work. Connect With Public Consulting Group Connect with Public Consulting Group > Job Locations

US-CA-Sacramento | US Posted Date3 months ago(8/5/2021 1:39 PM) Job ID 2021-6926 # of Openings 1 Category Consulting Type Regular Full-Time Practice Area Technology Consulting Public Consulting Group is an equal opportunity employer.

All qualified applicants receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, protected veteran status, or status as a qualified individual with a disability.

VEVRAA Federal Contractor.

calendar_today 2 days ago

 
 

Clipped from: https://us.bebee.com/job/20211031-d11ad51ed281d403bb22ab04b8c2b1b4?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Director, Financial Planning and Analysis – KS Medicaid CFO at CVS Health

 
 

Position SummaryThis role must reside near Overland Park, KS office location

You must reside in KS or be willing to relocate near commutable distance to office location

Relocation Assistance Considered.We are hiring a finance leadership role! Aetna, a CVSH Health Fortune 4 company is hiring a Finance lead to support Kansas Medicaid

You will be full-time office based with some work from home opportunity

Must reside in Kansas and be within commutable distance to office location

The Chief Financial Officer (CFO) will implement a defined management process for driving best practices within functions of responsibility

You will direct a group of 4 financial professionals

You oversee the implementation and monitoring of financial functions that support the business units’ financial plans

You may participate in projects that impact all functional disciplines (non-financial) of the company

You will report to the Executive Director, Regional CFO.Fundamental Components:• Oversee the Kansas Medicaid Plan’s budget and forecasting processes

Have access to an actuary and ensure that the Kansas Plan meets state requirements for financial performance and reporting.• Evaluate and analyze the financial impact of key business strategies (i.e

market investments, market exits, acquisitions, etc.).• Analyze and critically evaluate growth opportunities.• Direct the evaluation of business area projects, challenging financial resources, resolving expense savings.• Support the coordination and development of business unit financial plans and forecasts.• Oversee the implementation of processes for achieving business goals.• Manage a team of 4 associates and position for future growthRequired Qualifications• Minimum 10+ years financial experience including strategic and business planning, financial planning, analysis, P&L, reporting or accounting• Industry knowledge of Healthcare/managed care, insurance• Leadership and people manager experience• Project Management and Process Improvement experience.• Travel 5-10% of the time

In-state travel requires use of personal vehicle

Have valid/active driver’s license and proof of vehicle insurance

Some travel out of state also anticipated for internal meetings.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment

For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment

Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health

As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated

If your request for an accommodation is not approved, then your employment may be terminated.Preferred Qualifications• Medicaid Product knowledge• Advanced degree in Business and/or FSA/CPA• Degree in Finance, Accounting, Actuarial Science, or similar disciplines#LI-DI1Education• Bachelor’s Degree requiredBusiness OverviewAt CVS Health, we are joined in a common purpose: helping people on their path to better health

We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused

Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart

We strive to promote and sustain a culture of diversity, inclusion and belonging every day

CVS Health is an equal opportunity and affirmative action employer

We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law

We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.Req ID1728849BRClinical Licensure RequiredN/A Job CategoryAccounting and Finance, Aetna, Aetna Better Health, MedicaidBusiness AreaCVS Health Job Type (Expected Hours Category)Full Time Location – State/CityKS – Kansas City, KS – Lawrence, KS – Leawood, KS – Lenexa, KS – Olathe, KS – Overland Park, KS – Prairie Village, KS – Shawnee, MO – Belton, MO – Kansas City, MO – Raymore, MO – Raytown, OK – Oklahoma CityLocation codeAO057Street Address9401 Indian Creek ParkwayCityOverland ParkStateKSZip Code66210CountryUnited States FLSAExempt Requisition TemplateProfessionalSourcing RequisitionNoNo

of Positions1

 
 

Clipped from: https://tarta.ai/j/7YaM13wBPV406l6XMT_e-director-financial-planning-and-analysis-ks-medicaid-cfo-in-olathe-ks-kansas-at-cvs-health?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Posted on

Professional Medicaid Trainer job in Madison

 
 

 
 

Found in: Whatjobs US Premium

Description:

Gainwell Technologies LLC

Job Description

Essential Job Functions
* Researches, writes, edits, and proofreads more complex technical data for use in documents or sections of documents such as manuals, procedures and specifications to provide clients with information regarding technical areas in a less technical way.
* Assists in establishing style guidelines and standards for texts and illustrations to meet business needs.
* Interviews programmers, engineers, developers, and other technical personnel;. Reads previous documentation and design notes, and uses computer based training or company technical products to gather and research technical information for use in more complex documentation.
* Writes, organizes, enters and compiles more complex online help files to support end users.
* Creates, compiles, and delivers more complex system/software developmental documentation packages including, but not limited to narratives, logic diagrams, input and output samples, input preparation instructions, job setup information, etc., from technical project team inputs, system requirements analysis, system design specifications, technical system design, technical procedure development, configuration control requirements, test and training specifications, and programming notes.
* Assists in creating project plan, etc. for completing documentation.
* Provides leadership and work guidance to less experienced personnel.
Basic Qualifications
* Bachelor’s degree or equivalent combination of education and experience
* Bachelor’s degree in communications, journalism, technical writing or related field preferred
* Three or more years of technical writing experience
* Experience working with desktop publishing, word processing, and on-line documentation software
* Experience working with industry writing style such as grammar, sentence form, and structure
* Experience working with company software products
Other Qualifications
* Strong communication skills
* Personal computer and business solutions software skills
* Good proofreading and editing skills
* Ability to convert technical knowledge into easily understood terms
* Ability to work independently and as part of a team
Work Environment
* Office environment


3 days ago

 
 

Clipped from: https://us.trabajo.org/job-982-20211031-419b1c8de6253c744e7398cad8702257?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Director of Proposal Strategy – Medicaid

 
 

Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time


 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.  This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company.

Our Government Business Division’s Growth Team is looking for a Director of Proposal Strategy to join its Proposal and Capture Group.  Our Director of Proposal Strategy is a People Leader role responsible for leading the strategy, planning, and direction of individual Medicaid proposals, ensuring that the strategy and content identified in our Capture work translate to the proposal in a compliant and compelling way.

[This position can work remotely from any US Anthem location]

Primary duties may include, but are not limited to: Plans, organizes, and manages the work of the Proposal Management unit to support Medicaid, Duals, and specialty products business acquisition in new and existing markets. Oversees all aspects of the proposal development process. Develops bid strategies and strategic positioning of growth opportunities on individual RFPs, RFIs and other sole source opportunities. Conducts in-depth strategic/market research. Provides analytical and strategic development support, including the analysis and synthesis of business, technical, and government documents with a high attention to detail. Works closely with senior management, health plan leaders, and broad cross-functional staff. Serves as primary interface to the Business Owners and Functional Leaders during the proposal development process. Manages contracted/outsourced resources to augment existing staff to respond to proposals. Hires, trains, coaches, counsels, and evaluates performance of direct reports. 

Qualifications

Requires a BA/BS degree in a related field and a minimum of 7 years of related experience including prior leadership experience; or any combination of education and experience, which would provide an equivalent background. 

Highly preferred experience:

 -Experience with Medicaid business development pursuits.

-Experience with large Healthcare backed custom Government proposals. 

-Experience leading the strategy of multiple competing proposal life cycles at once.

-Experience presenting to, liaising with Executives, and cultivating relationships at the Executive level.

-Association of Proposal Management Professional (APMP) membership and certification preferred. 

-MBA or MPH preferred. 

-Ability to travel.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

 
 

Clipped from: https://anthemcareers.ttcportals.com/jobs/7690114-director-of-proposal-strategy-medicaid?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Business Analyst- Medicaid/ MMIS, Colorado – Blackberry Jobs

 
 

CSG Government Solutions is a national leader in planning, managing and supporting complex projects that modernize the information technology and business processes of large government programs. For more than 20 years, we have applied our expertise, innovation, and results-oriented mindset to the most complex program modernization projects of over 150 government and other organizations including 44 state governments, the U.S. Department of Health and Human Services, the U.S. Department of Labor, and large municipal governments.


CSG provides multiple service offerings to our valued clients.


PMO by CSG brings all the expertise and experience needed to establish and operate a “full-service” PMO.
IV&V by CSG provides independent insight into all aspects of a project, with a focus on risk identification, analysis, and mitigation.
QA BY CSG deploys highly experienced teams and innovative methods, knowledge, and tools to assure that complex projects achieve our client’s objectives.
Strategy BY CSG brings our high-value resources to provide insight into best practices
OCM by CSG℠ operates on the principle that people are the key to realizing and sustaining the benefits of program modernization.


CSG is seeking business analysts with 3+ years of Medicaid and MMIS experience to join our consulting staff. You will work on highly productive project teams delivering our services to state government agencies nationwide. The responsibilities and qualifications are as follows:


Responsibilities and Qualifications include:


Working as member of a project team functioning as a business analyst for large-scale technology projects utilizing agile methodologies
Facilitating the elicitation and documentation of business requirements and joint application design sessions
Reviewing functional and technical requirements and design specifications
Analyzing business processes and workflows
Conducting quality reviews of design documents
Conducting quality reviews of test plans and procedures
Analyzing requirements traceability throughout the system development life cycle
Facilitating the development of test scripts and test data necessary for performing user acceptance testing
Creating project documentation including meeting minutes, deliverables, project status reports and presentations
Tracking issues, risks, action items and decisions using standard project management techniques and tools
Communicating project issues and risks to the project management team
Familiar with MMIS Certification Process, a plus
Experience with Medicaid Enterprise Checklist Toolkit (MECT) framework, a plus
Experience with MMIS planning, procurement, and/or operations, a plus
Knowledge of Medicaid Information Technology Architecture (MITA), a plus


Travel may be necessary from 25%- 50% under normal circumstances. Must be able to work remotely in a productive manner if the COVID-19 situation limits travel.


Assistance with relocation may be an option in certain circumstances.


**All candidates authorized to work in the US without sponsorship are eligible to apply**


Working at CSG


Clients trust us with their most difficult challenges, so we have to be at the top of our game. And you will be, too. You’ll also find that we’re able to keep it in perspective, combining a strong work ethic with an appreciation for a balanced life.


It’s a team atmosphere, where dedicated professionals with complementary talents encourage one another to do their best work in an environment focused on integrity, growth, and excellence. These are just a few of the many reasons why CSG has been named one of America’s Best Management Consulting Firms three years in a row by Forbes Magazine.


Our Focus on Professional Development


We’re dedicated to the personal growth of our employees and have programs that enable you to enhance your skills and pursue your career goals within our company.


Our Professional Development group works with you to develop an individual Professional Development Plan (PDP) that aligns your goals with the skills we need to deliver the highest quality services to our clients. Your PDP addresses staffing assignments, training and other factors that keep you on the path to a rewarding career.


Our training program, The CSG Way, is focused on continuously developing the skills of our employees and sharing knowledge across our organization. The program includes courses that develop your analytical, management, and leadership skills; expand your program knowledge; and prepare you for project assignments.


Benefits


Competitive Benefits including Medical and Dental Insurance, Life Insurance, Short-Term and Long-Term Disability Insurance, 401k with employer match, Paid Vacation and Holidays


For more information about CSG Government Solutions visit .


CSG Government Solutions is an Equal Opportunity Employer. M/F/D/V

 
 

Clipped from: https://blackberryjobs.co.uk/jobs/business-analyst-medicaid-mmis-colorado/410285240-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on

Provider Network Account Executive II – Medicaid – Expert Contract Negotiator – Amerihealth

 
 

Your career starts now. Were looking for the next generation of health care leaders.

At AmeriHealth Caritas, were passionate about helping people get care, stay well and build healthy communities. As one of the nation’s leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, wed like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at .

Responsibilities:

The AE II is responsible for building, nurturing and maintaining positive working relationships between Plan and its contracted providers. Assigned provider accounts may include single or multiple practices in single or multiple locations, integrated delivery systems or other provider organizations. AE II maintains in depth understanding of Plans contracts and provider performance and needs, identifying, developing and conducting relevant and tailored provider orientation sessions, making educational visits and working to resolve provider issues. Responsible for monitoring and managing provider network by assuring appropriate access to services throughout the Plans territory in keeping w/ State and Federal contact mandates for all products. Identifies, contacts and actively solicits qualified providers to participate in Plan at new and existing service areas and products, assuring financial integrity of the Plan is maintained and contract management requirements are adhered to, including language, terms and reimbursement requirements. Maintains complete understanding of Plan reports and metrics and uses them to evaluate the performance of assigned providers/practices/facilities, determining, communicating and implementing plans for providers to improve performance and measuring ongoing performance. Uses data to develop and implement methods to improve relationship. Assists in corrective actions required up to and including termination, following Plan policies and procedures. Supports the Quality Management department with the credentialing and re-credentialing processes, investigation of member complains and any potential quality issues. Maintains a functional working knowledge of Facets, including the provider database and routinely relays information about additions, deletions or corrections to the Provider Maintenance Department. Maintains and delivers accurate, timely activity and metric reports as required. Identifies and maintains strong partnerships with appropriate internal resources and stakeholders.

An AE IIs accounts/assignments include:

  • Those that are most complex, a higher number of multiple practice locations and multi-specialty practices and multiple providers.
  • A total practice annual pay amount over $1M
  • Those that impact a total member population of a minimum of 5,000 or more. The appropriate minimum number of member population impact for the AE II level is determined by each Plan according to their business environments.

The AE II is responsible for managing an ongoing Provider Network Management organization project or program.

Will develop/implement/manage programs and projects that support/impact high dollar and high member provider groups.

The AE II is responsible for participating or independently developing and implementing Provider Network education programs and materials (both internal and provider targeted) and is assigned to train, mentor and support new AEs. The AE II will assist AE Is in resolving/managing issues with Providers.


Education/Experience:

  • Bachelors Degree.
  • Experience in a Provider Services position working with providers.
  • Experience in the managed care/health insurance industry with demonstrated strengths in: knowledge of Plan policies and procedures related to provider contracting, provider credentialing, provider billing and payment, provider incentive programs and other key State and Federal regulatory requirements related to providers, claim adjudication systems, provider file database requirements and relevant software applications; working independently and managing complex projects and programs both as an independent owner and team leader, training and mentoring skills, interacting at an executive level internally and externally.
  • Substantive Account Executive experience with high impact, high dollar, extremely visible and critical provider groups.


 
 

Back Share Apply Now

 
 

Clipped from: https://tarta.ai/j/hoQu13wBPV406l6XH-sN-provider-network-account-executive-ii-medicaid-expert-contract-negotiator-toledo-oh-job-in-toledo-at-amerihealth?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on

Medicaid State Operations Analyst, Shelbyville, Kentucky

 
 

Medicaid State Operations Analyst

  • Job Reference: 410218396-2
  • Date Posted: 31 October 2021
  • Recruiter: Anthem, Inc
  • Location: Shelbyville, Kentucky
  • Salary: On Application
  • Sector: I.T. & Communications
  • Job Type: Permanent

Apply for this job now

Job Description

Description SHIFT: Day JobSCHEDULE: Full-timeRequirements: + BA/BS degree+ Minimum of 5 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry+ Or any combination of education and experience which would provide an equivalent background We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.Qualifications Requirements: + BA/BS degree+ Minimum of 5 years of claims research and/or issue resolution or analysis of reimbursement methodologies within the health care industry+ Or any combination of education and experience which would provide an equivalent background We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions. REQNUMBER: PS59559-Kentucky


 
 

Clipped from: https://jobs.cu-fc.com/jobs/medicaid-state-operations-analyst-shelbyville-kentucky/410218396-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on

MEDICAID ANALYST 1-3 (MEDICAID ANALYST) | Government Jobs

 
 

Job Details

MEDICAID ANALYST 1-3 (MEDICAID ANALYST)

This listing closes on 11/15/2021 at 11:59 PM Central Time (US & Canada).

Salary

$2,309.00 – $4,453.00 Monthly

Location

Hammond, LA

Job Type

Classified

Department

LDH-Medical Vendor Administration

Job Number

MVA/CSH/146845

Closing date and time

11/15/2021 at 11:59 PM Central Time (US & Canada)

Supplemental Information

 
 

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Eligibility Region 9 / Tangipahoa Parish  
 
 Announcement Number: MVA/CSH/146845
 Cost Center: 3052050410
 Position Number(s): 50592988
 
This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary or Promotional appointment.
 
Applicants must have Civil Service test scores for 8100-Professional Level Exam in order to be considered for this vacancy unless exempted by Civil Service rule or policy. If you do not have a score prior to applying to this posting, it may result in your application not being considered.
 
Applicants without current test scores can apply to take the test here.
 
The Medicaid Analyst (MA) is a position responsible for acquiring extensive knowledge of Medicaid policy and procedures and using same to make timely and accurate Medicaid eligibility determinations. The MA is responsible for providing eligibility assistance to members and applicants in the manner of their choosing which may be electronic, by mail, by email, in person, or most often by phone. This position requires competency of web-based programs. Work conditions are a combination of sedentary work on a computer and assistance to members by phone in a call-center format. The ideal candidate is an individual who works independently, is detail-oriented, has excellent customer service skills, can perform routine activities, is attentive to deadlines, and is a team player. Medicaid eligibility is fundamental to the overall Medicaid program, and mastery of eligibility policy and procedure may provide a path for career growth in the health insurance field.
 
As part of a Career Progression Group, vacancies may be filled from this recruitment as a Medicaid Analyst 1, 2 or 3 depending on the level of experience of the selected applicant(s).  The maximum salary for the Medicaid Analyst 2 is $57,179.  The maximum salary for the Medicaid Analyst 3 is $$70,117 . Please refer to the ‘Job Specifications’ tab located at the top of the LA Careers ‘Current Job Opportunities’ page of the Civil Service website for specific information on salary ranges, minimum qualifications and job concepts for each level. 
 
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:
 Casey Hickman
 
Casey.Hickman@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.     

Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree.

 
 

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 will substitute 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.

NOTE:
Any college hours or degree must be from a school accredited by one of the following regional accrediting bodies: the Middle States Commission on Higher Education; the New England Association of Schools and Colleges; the Higher Learning Commission; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges.

 
 

NOTE:

An applicant may be required to possess a valid Louisiana driver’s license at time of appointment.

Job Concepts

FUNCTION OF WORK:

To make initial and continuing determination, under close supervision, as to clients’ eligibility for all Medicaid programs.

 
 

LEVEL OF WORK:

Entry.

 
 

SUPERVISION RECEIVED:

Medicaid Analysts typically report to a Medicaid Analyst Supervisor. May receive supervision from higher level personnel.

 
 

SUPERVISION EXERCISED:

None.

 
 

LOCATION OF WORK:

Department of Health and Hospitals, Medical Vendor Administration.

 
 

JOB DISTINCTIONS:

Differs from Medicaid Analyst 2 by the presence of close supervision and the absence of independent action.

Examples of Work

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

 
 

Under close supervision, the entry level Medicaid Analyst learns to perform the following duties:

 
 

Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs.

 
 

Examines application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.

 
 

Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the rolldown procedure.

 
 

Interprets and applies complex federal, state, and agency policies for each program.

 
 

Conducts special investigations and compiles reports concerning fraud and location of absent parents.

 
 

Counsels and refers potentially eligible recipients or applicants to other agencies.

 
 

Contacts individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information. 

 
 

Records findings, recommendations, and services provided; completes case record forms and necessary correspondence in connection with assigned cases.

Benefits

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to “make a difference” through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career. As a state employee, you will earn competitive pay, choose from a variety of benefits and have access to a great professional development program.

Flexible Working Arrangements – The flexibility of our system allows agencies to implement flexible working arrangements through the use of alternative work schedules, telecommuting and other flexibilities. These arrangements vary between hiring agencies.

Professional Development – The Comprehensive Public Training Program (CPTP) is the state-funded training program for state employees. Through CPTP, agencies are offered management development and supervisory training, and general application classes on topics as diverse as writing skills and computer software usage.

Insurance Coverage – Employees can choose one of several health insurance programs ranging from an HMO to the State’s own Group Benefits Insurance program. The State of Louisiana pays a portion of the cost for group health and life insurance. Dental and vision coverage are also available. More information can be found at www.groupbenefits.org.

Deferred Compensation – As a supplemental retirement savings plan for employees, the State offers a Deferred Compensation Plan for tax deferred savings.

Holidays and Leave – State employees receive the following paid holidays each year: New Year’s Day, Martin Luther King, Jr. Day, Mardi Gras, Good Friday, Memorial Day, Independence Day, Labor Day, Veteran’s Day, Thanksgiving Day and Christmas Day. Additional holidays may be proclaimed by the Governor. State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works).  These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to): Louisiana State Employees Retirement System (www.lasersonline.org), Teacher’s Retirement System of Louisiana (www.trsl.org), Louisiana School Employees’ Retirement System (www.lsers.net), among others. LASERS has provided this video to give you more detailed information about their system.

Agency State of Louisiana Phone (866) 783-5462 Website http://agency.governmentjobs.com/louisiana/default.cfm

Address For agency contact information, please refer to
the supplemental information above.
Louisiana State Civil Service, Louisiana, 70802

 
 

Clipped from: https://www.governmentjobs.com/jobs/3293602-0/medicaid-analyst-1-3-medicaid-analyst?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Posted on

Director Clinical Programs (Mississippi Medicaid Managed Care) in , Mississippi, United States

 
 

Description:

Description

SHIFT: Day Job

SCHEDULE: Full-time


 

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America’s leading health care companies and a Fortune Top 50 Company.

We are hiring a Director of Clinical Programs. Responsible for evaluating, developing, and implementing clinical program components to optimize care management and product strategies and goals. This position is focused on behavioral health services.

Primary duties may include, but are not limited to:

  • Supports the sales/marketing process for new and existing clients through the delivery of program presentations and showcasing program value and outcomes to clients/prospects.
  • Interfaces with clients, medical directors, physicians, and other healthcare professionals in the sales process and the ongoing development of provider collaboration strategies.
  • Develops and implements, in conjunction with the program development team, clinical programs, enhancements, and products consistent with the product strategy.
  • Collaborates with operations, IT, informatics, sales and marketing, and client services on program design and delivery.
  • Supports the Program Development team in the evaluation and management of projects.
  • Manages the deployment of clinical data through the operations directors.
  • Serves as a clinical resource to operations management teams, informatics, and reporting teams in the development of evaluation models and reporting.
  • Performs system-wide clinical analysis to identify and recommend disease management clinical strategies and goals to achieve/exceed program goals and targets (for new and existing clinical conditions).
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

 
 

Qualifications

The health and safety of our associates, members and communities is a top priority for Anthem.  This priority has become increasingly important as we continue to face the challenges of the COVID-19 pandemic.  Anthem believes vaccination is the best way to reduce the spread of COVID-19 and protect our members, our communities, our families and ourselves. To minimize the risk of transmission of the COVID-19 virus and maintain a safe and healthy workplace, vaccination is required for this role. (At Anthem, fully vaccinated means it has been at least two weeks since you have received the second dose of a two-dose vaccine such as Moderna or Pfizer, or the single dose of a single dose vaccine, such as Johnson & Johnson).

 
 

If you do not meet the requirements for this position, we encourage you to review other positions that currently allow virtual work.  If you have a medical or sincerely held religious reason for not being vaccinated, consistent with applicable law, Anthem will consider requests for reasonable accommodation on this basis.  Should you have any questions regarding the requirement after applying, email TalentAcquisition_VaccinationSupport@anthem.com.

Minimum Requirements

Requires MS in public health, health education, public policy, health administration or a related field and minimum of 6 years of experience in a health care environment, health education program planning or social service which includes a minimum of 2 years managed care experience and minimum of 2 years prior management experience and a minimum of 2 years of experience directing, implementing, and managing large projects; or any combination of education and experience, which would provide an equivalent background.

Experience in public speaking at conferences and other public venues required

Position must reside in Mississippi

Preferred Qualifications

PhD in public health, health education, public policy or health administration preferred.

LCSW strongly preferred

Utilization management and case management experience preferred

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.


Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

 
 

Clipped from: https://anthemcareers.ttcportals.com/jobs/7808669-director-clinical-programs-mississippi-medicaid?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Posted on

MEDICAID ANALYST 1-3 (MEDICAID ANALYST) | Government Jobs

 
 

Job Details

MEDICAID ANALYST 1-3 (MEDICAID ANALYST)

This listing closes on 11/15/2021 at 11:59 PM Central Time (US & Canada).

Salary

$2,309.00 – $4,453.00 Monthly

Location

Monroe, LA

Job Type

Classified

Department

LDH-Medical Vendor Administration

Job Number

MVA/CSH/146841

Closing date and time

11/15/2021 at 11:59 PM Central Time (US & Canada)

Supplemental Information

 

 
This position is located within the Louisiana Department of Health / Medical Vendor Administration / Eligibility Region 8 / Ouachita Parish  
 
 Announcement Number: MVA/CSH/146841
 Cost Center: 3052050409
 Position Number(s): 50593000, 50593052, 50593072
 
This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary or Promotional appointment.
 
Applicants must have Civil Service test scores for 8100-Professional Level Exam in order to be considered for this vacancy unless exempted by Civil Service rule or policy. If you do not have a score prior to applying to this posting, it may result in your application not being considered.
 
Applicants without current test scores can apply to take the test here.
 
The Medicaid Analyst (MA) is a position responsible for acquiring extensive knowledge of Medicaid policy and procedures and using same to make timely and accurate Medicaid eligibility determinations. The MA is responsible for providing eligibility assistance to members and applicants in the manner of their choosing which may be electronic, by mail, by email, in person, or most often by phone. This position requires competency of web-based programs. Work conditions are a combination of sedentary work on a computer and assistance to members by phone in a call-center format. The ideal candidate is an individual who works independently, is detail-oriented, has excellent customer service skills, can perform routine activities, is attentive to deadlines, and is a team player. Medicaid eligibility is fundamental to the overall Medicaid program, and mastery of eligibility policy and procedure may provide a path for career growth in the health insurance field.
 
As part of a Career Progression Group, vacancies may be filled from this recruitment as a Medicaid Analyst 1, 2 or 3 depending on the level of experience of the selected applicant(s).  The maximum salary for the Medicaid Analyst 2 is $57,179.  The maximum salary for the Medicaid Analyst 3 is $$70,117 . Please refer to the ‘Job Specifications’ tab located at the top of the LA Careers ‘Current Job Opportunities’ page of the Civil Service website for specific information on salary ranges, minimum qualifications and job concepts for each level. 
 
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:
 Casey Hickman
 Casey.Hickman@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.    

Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree.

 
 

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 will substitute 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.

NOTE:
Any college hours or degree must be from a school accredited by one of the following regional accrediting bodies: the Middle States Commission on Higher Education; the New England Association of Schools and Colleges; the Higher Learning Commission; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges.

 
 

NOTE:

An applicant may be required to possess a valid Louisiana driver’s license at time of appointment.

Job Concepts

FUNCTION OF WORK:

To make initial and continuing determination, under close supervision, as to clients’ eligibility for all Medicaid programs.

 
 

LEVEL OF WORK:

Entry.

 
 

SUPERVISION RECEIVED:

Medicaid Analysts typically report to a Medicaid Analyst Supervisor. May receive supervision from higher level personnel.

 
 

SUPERVISION EXERCISED:

None.

 
 

LOCATION OF WORK:

Department of Health and Hospitals, Medical Vendor Administration.

 
 

JOB DISTINCTIONS:

Differs from Medicaid Analyst 2 by the presence of close supervision and the absence of independent action.

Examples of Work

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

 
 

Under close supervision, the entry level Medicaid Analyst learns to perform the following duties:

 
 

Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs.

 
 

Examines application packets for timeliness, completeness, and appropriateness prior to authorization of reimbursement.

 
 

Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the rolldown procedure.

 
 

Interprets and applies complex federal, state, and agency policies for each program.

 
 

Conducts special investigations and compiles reports concerning fraud and location of absent parents.

 
 

Counsels and refers potentially eligible recipients or applicants to other agencies.

 
 

Contacts individuals, companies, businesses, local, state and federal agencies as needed to obtain or to verify information. 

 
 

Records findings, recommendations, and services provided; completes case record forms and necessary correspondence in connection with assigned cases.

Benefits

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to “make a difference” through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career. As a state employee, you will earn competitive pay, choose from a variety of benefits and have access to a great professional development program.

Flexible Working Arrangements – The flexibility of our system allows agencies to implement flexible working arrangements through the use of alternative work schedules, telecommuting and other flexibilities. These arrangements vary between hiring agencies.

Professional Development – The Comprehensive Public Training Program (CPTP) is the state-funded training program for state employees. Through CPTP, agencies are offered management development and supervisory training, and general application classes on topics as diverse as writing skills and computer software usage.

Insurance Coverage – Employees can choose one of several health insurance programs ranging from an HMO to the State’s own Group Benefits Insurance program. The State of Louisiana pays a portion of the cost for group health and life insurance. Dental and vision coverage are also available. More information can be found at www.groupbenefits.org.

Deferred Compensation – As a supplemental retirement savings plan for employees, the State offers a Deferred Compensation Plan for tax deferred savings.

Holidays and Leave – State employees receive the following paid holidays each year: New Year’s Day, Martin Luther King, Jr. Day, Mardi Gras, Good Friday, Memorial Day, Independence Day, Labor Day, Veteran’s Day, Thanksgiving Day and Christmas Day. Additional holidays may be proclaimed by the Governor. State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works).  These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to): Louisiana State Employees Retirement System (www.lasersonline.org), Teacher’s Retirement System of Louisiana (www.trsl.org), Louisiana School Employees’ Retirement System (www.lsers.net), among others. LASERS has provided this video to give you more detailed information about their system.

Agency State of Louisiana Phone (866) 783-5462 Website http://agency.governmentjobs.com/louisiana/default.cfm

 
 

Clipped from: https://www.governmentjobs.com/jobs/3293549-0/medicaid-analyst-1-3-medicaid-analyst?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic