Medicare & Buy-In Policy Analyst
Medicare & Buy-In Policy Analyst
Posted on :
01-09-2025
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1 Vacancy
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Job Description
Description and Functions
- Open Until Filled
GENERAL DESCRIPTION:The Wyoming Department of Health Division of Healthcare Financing is seeking applicants for the position of Medicare and Buy-In Program Analyst. This position is responsible for the management and administration of the Medicare Buy-In and Medicare Savings Programs and the coordination of benefits related to Medicare.
Human Resource Contact:
ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function that may be performed in the job level.- Develop policy state plans rules and regulations based on federal and state laws through research analysis design implementation and evaluation for current and proposed programs and coordinate the rules and policy adoption process to ensure compliance.
- Coordinate and maintain policy manual related to Medicare Savings Programs dual eligibility and Medicare Buy-In.
- Develop educational and outreach materials for the public as well as internal and external divisions and agencies.
- Determined data collection requirements and needs and analyzed data.
- Understand and monitor program budgets and recommend funding decisions and program operation policies and procedures by tracking premiums paid and costs avoided by ensuring Medicare is the primary payer.
- Program planning and development of long and short-range changes to the Medicare Savings Programs and the effect the changes will have on the Wyoming Medicaid Program.
- Coordinates with the Social Security Administration Wyoming State Health Insurance Information Program (WSHIIP) Medicaid Fiscal Agent and other agencies to ensure quality initiatives are being met for Medicare and Medicaid dual eligibility.
- Research potential program options to improve access.
- Program Reporting and Analysis related to the Medicare Savings Programs Crossover Claims Medicare Parts C &D and Medicare and Medicaid Dual Eligible Medicare Coverage Benefits and Rates.
- Assisting in coordination between other agencies and units including other sections within the Department of Health.
- Review and resolve Buy-Int tasks from the Center for Medicare and Medicaid Services (CMS) daily.
- Review monthly Buy In invoice reports for accuracy make up dates as necessary to Buy-
- In categories and approve the Buy-In invoices for payment.
- Oversee the D-SNP contract and monthly reporting.
- Review monthly reports in the Client Services Unit to identify errors correct cases and report on patterns.
- Other duties as assigned.
Qualifications
PREFERENCES:Preference will be given to individuals with experience with Medicare and Medicaid eligibility programs.
KNOWLEDGE:- Knowledge of the management of programs.
- Knowledge of state and federal government functions procedures concepts principles and practices of professional healthcare administration.
- Ability to comprehend federal regulations state statutes program rules and policy and to interpret and integrate into legislation statute and policy.
- Knowledge of the Medicaid Management Information System and the Eligibility System and their application to Medicaid programs.
- Ability to examine data and reports for completeness accuracy and conformance with regulations.
- Knowledge of good oral and written communication skills.
- Knowledge of the latest forms of technology and the ability to use this knowledge to create and present Medicaid program information to various audiences across the state.
- Knowledge of the aspects of Healthcare Reform that directly impact Medicaid programs and the ability to plan and create materials that clarify the process.
- Knowledge of all Medicaid programs.
- Skill and ability to work independently.
MINIMUM QUALIFICATIONS:Education:Bachelors DegreeExperience:0-3 years of progressive work experience (typically in Benefits and Eligibility) with acquired knowledge at the level of a Senior Benefits and Eligibility SpecialistOREducation & ExperienceSubstitution:4-6 years of progressive work experience (typically in Benefits and Eligibility) with acquired knowledge at the level of a Senior Benefits and Eligibility SpecialistCertificates Licenses Registrations:NoneNecessary Special Requirements
PHYSICAL WORKING CONDITIONS:- The employee may sit comfortably to perform the work; however there may be some walking standing bending carrying light items driving an automobile etc.
NOTES:- FLSA: Non-exempt
- The Wyoming Department of Health is anE-Verifyemployer.
Supplemental Information
048-Wyoming Department of Health - Division of Healthcare Financing
Clickhere to view the State of Wyoming Classification and Pay Structure.
URL: State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.
Class Specifications are subject to change please refer to the A & I HRD Website to ensure that you have the most recent version.
Required Experience:
IC
Employment Type
Full-Time
Key Skills
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