Medicaid Program Specialist I (Certification Reviewer, PCN 062351)
Job Location:
Anchorage, AK - USA
Monthly Salary:
Posted:
Application Deadline:
Vacancies:
Job Summary
- Job Description
This Individual Position is Exempt from the Hiring Freeze. Qualified Applicants are Encouraged to Apply.
Welcome to the Department of Health.
Wed be delighted to have you join our team.
If you envision yourself in this role and are ready to start an exciting career with us apply today.
This position is open to Alaskan Residents only.
What you will be doing:
As the Medicaid Program Specialist I Certification Reviewer you will play a key role in the certification process for current and prospective Medicaid Home and Community-Based Services (HCBS) providers. As a member of the Provider Certification and Compliance Unit you will be primarily responsible for reviewing and evaluating applications in accordance with applicable standards for HCBS providers (waiver and personal care services) who apply to obtain or maintain certification to participate in Medicaid.
You will review and analyze provider documentation and issue determinations on certification applications track and trend issues with providers and make recommendations for quality improvement addition you will serve in a vital technical assistance role for providers as well as process changes in provider statuses during certification periods. Collaboration with appropriate partner agencies and referrals for inappropriate service provisions and/or non-compliance are also included in the duties of this position.
Some Travel may be required in this postion.
Our organization mission and culture:
Senior and Disabilities Services promotes health well-being and safety for individuals with disabilities seniors and vulnerable adults by facilitating access to quality services and supports that foster independence personal choice and dignity.
The benefits of joining our team:
You will work with a talented dedicated and professional team that is driven to ensure quality services are provided to Alaskas most vulnerable citizens so they can thrive in their home communities. Working within a team of nine staff and in very close collaboration with other teams at SDS as well as other partner agencies there is ample opportunity to have a positive impact on the lives of Alaskans as well as gain valuable professional experience in the field of Medicaid compliance certification and quality assurance.
The working environment you can expect:
This position is located in East Anchorage next to East High School.
We are currently working in a hybrid teleworking model with a 90-day in-person office requirement during initial hire and training.
This position is mostly office/home based however some local travel may be required.
Who we are looking for:
The ideal candidate will possess some or all of the following position-specific competencies in addition to the minimum qualifications listed below:- Reading Comprehension:Understands and interprets written material including technical material rules regulations instructions reports charts graphs or tables; applies what is learned from written material to specific situations.
- Writing: Recognizes or uses correct English grammar punctuation and spelling; communicates information (for example facts ideas or messages) in a succinct and organized manner; produces written information which may include technical material that is appropriate for the intended audience.
- Interpersonal Skills: Shows understanding friendliness courtesy tact empathy concern and politeness to others; develops and maintains effective relationships with others; may include effectively dealing with individuals who are possibly difficult hostile or distressed; relates well to people from varied backgrounds and different situations; is sensitive to cultural diversity race gender disabilities and other individual differences.
To view the general description and example of duties for this job class please go to the following link and search for Medicaid Program Specialist: QualificationsCompetency-Based Minimum Qualifications Instructions
This job class uses competency-based minimum qualifications.Please ensure your application(through work history volunteer experience (duties summary) training education licenses certifications etc.) supports how you have gained the knowledge skills abilities and behaviors (competencies) and that you possess the minimum required competencies for the job class.
Competency Description
The competency description(s) listed below have been designed to promote a common understanding of the essential elements of the job class. They highlight the more general and customary knowledge skills abilities (KSAs) tasks and behaviors used to describe the competency. They typically list expectations rather than specific tasks and are to be used only as parameters and guidelines. A competencys description is not intended to exclusively define every KSA task and behavior needed to successfully meet the competency but rather to provide the manager/agency with a broad reference of options as to how an applicant can meet the job expectation.
Please ensure your application (through work history training education licenses certifications etc.) supports/demonstrates that you possess the minimum required competencies for the job class.Any combination of education and/or experience that provides the applicant with competencies in:
Analytical Thinking/Problem Solving:Uses a logical systematic and sequential approach to address problems or opportunities or manage a situation by drawing on ones knowledge and experience base and calling on other references and resources as necessary.Oral Communication: Expresses information (for example ideas or facts) to individuals or groups effectively taking into account the audience and nature of the information (for example technical sensitive controversial); makes clear and convincing oral presentations; listens to others attends to nonverbal cues and responds appropriately.Written Communication: Writes in a clear concise organized and convincing manner for the intended audience.equivalent to those typically gained by:
Experience such as supporting the administration of a Medicaid or Medicare program health insurance service health insurance management information system health insurance finance or accounting program Supplemental Security Income benefits or vocational rehabilitation program; auditing or monitoring medical or public assistance programs for fraud or quality assurance; processing medical claims using medical coding and medical billing knowledge and/or training or education which includes such course work as business administration computer sciences economics healthcare legal studies medical billing or coding public health public assistance psychology.
Special Note:
Competencies means a combination of interrelated knowledge skills abilities and behaviors that enable a person to act effectively in a job or situation.
Training and education in this guidance are synonyms for the process of acquiring knowledge and skills through instruction. It includes instruction through formal and informal methods (such as classroom online self-study and on-the-job) from accredited and unaccredited sources and long-duration (such as a post-secondary degree) and short-duration (such as a seminar) programs.
Typically gained by means the prevalent usual method of gaining the competencies expected for entry into the job.
Additional Required InformationPlease read the information below carefully. This applies to your application submission.
SUPPLEMENTAL QUESTIONS
For your application to be evaluated youmustanswer the Supplemental Questions.
The State of Alaska uses four proficiency levels to measure and describe an applicants competence in applying specific behaviors knowledge skills and abilities to accomplish a specific task. The four proficiency levels are Mastery Fluency Literacy and Discovery. You must rate your proficiency level for each competency listed in the supplemental questions.EDUCATION
To verify education is being used to meet and/or support the required minimum qualifications/competencies you must fill in the Education section of the application If you have not obtained a degree please indicate the number of units completed Copies of transcripts are required to verify educational credentials used to meet or support the minimum qualifications/competencies for a position and are required with each application (Unofficial is okay; please ensure the institution/URL name is listed on the transcripts) Transcripts can be attached at the time of application or provided at the time of interview; if not transcripts will be required before employment.
SPECIAL INSTRUCTIONS FOR FOREIGN EDUCATION
If education is completed in a foreign college or university it may be used to meet the above requirements if applicable. If utilizing this education you must show that the education credentials have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and that such education has been deemed to be at least equivalent to that gained in conventional U.S. education programs or an accredited U.S. state university reports the other institution as one whose transcript is given full value or full value is given in subject areas applicable to the curricula at the state university.It is your responsibility to provide such evidence when applying.The omission of the required documentation listed will result in an incomplete application and you will not receive further consideration.
WORK EXPERIENCE
When using work experience not documented in your application please provide the employers name job title employment dates and whether you worked full-time or part-time Applications will be reviewed to determine if the responses are supported and if minimum qualifications are met Work experience needed to meet the minimum qualifications must be documented in the application If the application does not support minimum qualifications the applicant may not advance to the interview and selection phase of the recruitment. A resume will not be used to determine that the minimum qualifications have been met for the position you are applying for.
If you have currently or previously been appointed to a flexibly staffed position please ensure your work experience within a flexibly staffed position indicates the actual dates employed at each level Ensure your time and any subsequent flex promotion(s) are documented as a separate position This is required as minimum qualifications require experience at a particular level in which the lower level may not be considered If this information is not accurately reflected in your application this may cause the processing of your application for consideration to be delayed.
NOTE: Attaching a resume or curriculum vitae is not an alternative to filling out the application.Noting see resume or CV or any similar response on any portion of your application may lead to a determination that your application is incomplete and removal from consideration for this job posting.
The State of Alaska does not provide VISA Employer sponsorships.MULTIPLE VACANCIES
This recruitment may be used for more than one (1) vacancy. The applicant pool acquired during this recruitment may be used for future vacancies for up to ninety (90) days after this recruitment closes. Interested applicants are encouraged to apply to each recruitment notice to ensure consideration for all vacancies.
APPLICATION NOTICE
You can ONLY apply for this position through the Workplace Alaska website or via a hard copy application. If you accessed this recruitment bulletin through a job search portal such as AlaskaJobs or another database you MUST use a Workplace Alaska online or hard-copy application to apply successfully. Instructions on how to apply with Workplace Alaska may be found on the Workplace Alaska How to Apply webpage found here: regarding the application process can be directed to the Workplace Alaska hotline at (toll-free) or (907) 465- 4095.If you choose to be contacted by emailplease ensure that your email address is correct on your application and that your spam filter will permit emails from the domain.For information on allowing emails from the domains visit the Lost Password Help page at: STATEMENT
The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA). Individuals with disabilities who require accommodations auxiliary aids or services or alternative communication formats please call 1- in Juneau or TTY: Alaska Relay 711 or 1- or correspond with the Division of Personnel & Labor Relations at P.O. Box 110201 Juneau AK 99811-0201. The State of Alaska is an equal-opportunity employer.
WORKPLACE ALASKA APPLICATION QUESTIONS & ASSISTANCE
Questions regarding application submission or system operation errors should be directed to the Workplace Alaska hotline at 1- (toll-free) or if you are in the Juneau area. Requests for information may also be emailed to.
For assistance with applying for a password please visit InformationFor specific information in reference to the position feel free to contact the hiring manager at:Kristen Bearden/Health Program Manager 2Phone:
Required Experience:
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