The Health Resources Division seeks to provide health care for low-income and disabled Montanans through Medicaid and the Healthy Montana Kids (HMK) Plan. As the Section Supervisor, this position is responsible for the Indian Health Service (IHS) and Tribal Programs for Montana Medicaid. The IHS and Tribal Section Supervisor is a highly visible position that represents Montana Medicaid in American Indian policy related matters; coordinates Indian policy work across Medicaid divisions and with other agencies; organizes and leads meetings or advisory groups; provides expert consultation to executive staff to ensure recognition of tribal authorities, interests and agreements; works closely with the Director’s Office Tribal Relations Manager; and assists in the development and enhancement of programs. This position will report directly to the Health Resources Division Administrator and will have two direct reports. *Below are more detailed job duties:* * Assisting in providing strategic guidance on consideration and inclusion of IHS/Tribal/Urban Indian Health concerns and in development of agency plans, programs and policies. * Assisting in efforts to expand overall engagement and partnership with IHS/Tribal/Urban Indian Health. * Developing and maintaining internal resources for staff, such as protocols and training, and externally facing resources for tribes. * Serving as a point of contact and assisting IHS/Tribes/Urban Indian Health in navigating the Medicaid and related programs. * Developing and ensuring positive working relationships with IHS/Tribes and tribal health partners across the state. * Reviewing and providing recommendations as appropriate on IHS/Tribal-related policies, procedures, and agreements. * Serves as a valuable resource; externally and cross functionally within the organization. * Further develop and promote, effective working partnerships between tribal governments, Montana Medicaid and other relevant agencies. * Develops and implements program health benefit coverage and reimbursement procedures based on state and federal Medicaid requirements, Administrative Rules of Montana (ARM), State Plan and other regulations. * Writes and updates administrative rules, statutes, and policies concerning IHS/Tribal /Urban Indian Health services program payment methodology, billing, coding, and administration of benefits and payment services. * Develops, implements, and monitors attainment of program goals and objectives. * Conducts File Updates Requests (FUR), checks and approves system files for uploads and makes recommendations for system changes based on federal changes, errors, etc. * Provides testimony on reimbursement rules and coverage when required at rule hearings, administrative reviews and fair hearings. * Serves as liaison to address coverage, reimbursement or eligibility issues. * Analyzes various types of internal and external data to determine types of educational opportunities to develop and deliver presentations on opportunities during tribal consultations and monthly IHS/Tribes calls. * Coordinate the implementation of any new and/or modified benefits for the tribal FQHCs and provide education to clinical staff and members. * Maintains provider relations and information network through oral and written communications, including group presentations and meetings to ensure patient access to services. * Represents the Division and actively participate as a subject matter expert for department data and claims processing systems. Provides input and feedback for design of the new systems such as necessary features and display requirements and functionality tests. * Participates in medical coverage reviews, setting of medical procedure limits, and determination of medical necessity. *Physical and Environmental Demands:* Work is performed in a typical office environment with keyboarding responsibilities. *This position will directly supervise two employees.* * Knowledge of cultural diversity and issues that impact a tribal community. * Knowledge of Montana Tribes, cultures, histories and government relations, including concepts of sovereignty and self-determination. * General knowledge of Medicaid and medical terminology * Knowledge of program management principles and practices. * Ability to analyze math calculations. * Expertise in spreadsheet software (Excel). * Excellent interpersonal and customer service skills * Excellent written and verbal communication skills * Ability to interpret and apply laws, rules and regulations. * Ability to identify and solve problems. * Knowledge and understanding of large databases including manipulation of data and the impact of changes. *Minimum Qualifications:* * Bachelor’s degree in human services; business, public, or health administration; or other related fields. * Two years of job related work experience in health policy, health program development, or health administration. * Other combinations of directly related education and experience may be considered on a case-by-case basis. * Experience in the medical service delivery system is preferred. * One year of supervisory experience is preferred. * Combinations of education and experience will be considered on a case-by-case basis. For a full copy of the job description, please e-mail Kaley Argee atkaley.argee2@mt.gov. *This position is posted with a primary location of Helena. The Hiring Manager will consider a remote work agreement if the successful applicant is not located in Helena.* *To be considered for this position, please submit the following materials online through the State of Montana Careers site:* * *Cover Letter* * *Resume* * *Supplemental Question:* o *Tell us about your experience with American Indian health care policy, Medicaid or any relevant work that would make you a good candidate for this position. * (Please type responses in a Word document and attach to application. HELPFUL HINT: When attaching a document, you much check the “relevant document” box to ensure your attachments are uploading correctly to the specific application. Please do not attach more than requested. If you have more than 25 attachments in the system you will need to email these to: hhshumanresources@mt.gov. Failure to attach the required material will conclude in an incomplete application. You must also keep those relevant boxes checked once you submit your application; if you uncheck the box with an active application it will delete the attachment.) The State of Montana offers a comprehensive benefits package, which includes: • 15 paid vacation days • 12 sick days • 10 paid holidays a year *To view State of Montana’s medical, dental, vision coverage, and other offerings, you can visit our Health Care and Benefits website at, t.gov/.* This is an open until filled position. /*To be considered for any DPHHS Agency position, applicants must complete and submit their application online, as well as upload any required application materials. Successful applicant(s) are required to successfully pass all DPHHS specific background check(s) relevant to each position.*/ **Job:** **Community/Social Services* **Title:** *IHS/Tribal Health Program Manager (01007)* **Location:** *Helena* **Requisition ID:** *21141098*
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Company Name State of Montana