Curator- Job Hunter – Page 123

Posted on March 19, 2021 by MM_ADMIN

Medicaid Contract Consultant | Chicago, IL | HCSC

Basic Function

This position is responsible for leadership and coordination of the assigned Medicaid programs in accordance with contractual and regulatory requirements, implementing program changes and working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the assigned Medicaid program are met. Also serves as the liaison with vendors and internal functional areas and assists in the coordination of the contract with state regulatory agencies.

Job Requirements

Bachelor Degree and 4 years experience in contract management OR 8 years experience in contract management.
Leadership experience
Project management/planning skills.
Experience in a position requiring independent and critical decision making skills.
Experience communicating with and relationship building with internal business units and/or various external government agencies.
Experience leading/providing guidance to intra and interdepartmental staff.
Experience accurately documenting information reported.
Organizational, analytical and decision-making skills.
Negotiation skills resulting in business/process improvements/changes.
Clear and concise interpersonal, verbal and written communication skills.
Presentation skills.
Project positive, professional image.

Preferred Job Requirements

Experience with corporate policies / procedures, compliance regulations in health care administration/managed care experience.

This position will be based in Chicago, IL.
Relocation assistance will not be provided for this position.
Sponsorship will not be provided for this position.

CA
#LI-HF1

Clipped from: https://www.themuse.com/jobs/hcsc/medicaid-contract-consultant-10fbbc?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on March 19, 2021 by MM_ADMIN

Medicaid Analyst 1

Job Details

Medicaid Analyst 1

This listing closes on 3/30/2021 at 11:59 PM Central Time (US & Canada).

Salary $13.32 – $25.69 Hourly $2,309.00 – $4,453.00 Monthly

$2,309.00 – $4,453.00 Monthly

Location Thibodaux, LA

Thibodaux, LA

Job Type

Classified

Department

LDH-Medical Vendor Administration

Job Number

MVA/KDC/1185

Closing date and time

3/30/2021 at 11:59 PM Central Time (US & Canada)

Supplemental Information

Job #: MVA/KDC/1185

This position is located within the LA. Department of Health/MVA/Eligibility/Lafourche Parish
Cost Center: 305-8381
Position #’s: 68405, 172436, 50345340

This vacancy is being announced as a classified position and may be filled as Probational, Promotional or a Job Appointment.
(Job Appointments are temporary appointments that may last up to 48 months)

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.

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.*

For further information about this vacancy contact:
Kelsi Chaney
LDH/Human Resources
P.O. Box 4818, Baton Rouge, LA 70821
Kelsi.Chaney@la.gov

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/3017046-0/medicaid-analyst-1?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on March 19, 2021 by MM_ADMIN

Supervising Special Agent, Medicaid Fraud Control Division at State of Washington

Persons requiring reasonable accommodation in the application process or requiring information in an alternative format may contact Kalea Muigai at 360-586-7698. Those with a hearing impairment in need of accommodation are encouraged to contact the Washington Relay Service at 1-800-676-3777 or www.washingtonrelay.com.

The Attorney General’s Office (AGO) is the chief legal officer for the state of Washington, serving more than 230 state agencies, boards, commissions, colleges and universities, as well as the Legislature and the Governor. In furtherance of its mission to deliver the highest quality professional legal services to officials, agencies, and people of the state of Washington, the AGO covers a remarkably diverse legal landscape, including consumer protection, civil and administrative litigation, environmental law, torts, tribal law, labor law, appellate practice, criminal prosecution and employment law.

The agency is highly respected for the quality of its legal work and the professionalism and ethical standards of its staff and leadership. The AGO’s dedicated team of more than 600 attorneys and 600 professional staff often cite the AGO’s broad mandate, offering challenging, diverse work in the public interest as reasons to join the office — and opportunities for professional growth, along with a collegial atmosphere, as reasons to stay. The AGO greatly encourages, celebrates and values diversity, appreciating that a workforce composed of those from different backgrounds and experiences creates an inclusive environment, strengthens positive relationships with the local community and brings new perspectives and approaches to fulfill its mission of providing excellent, independent and ethical legal services to the State of Washington and protecting the rights of its people.

For more information about the AGO, we encourage you to review the Office’s newest Annual Report which can be found HERE and view THIS VIDEO.

The Attorney General’s Office is recruiting for a permanent full time Supervising Special Agent (AGO Investigator/Analyst Supervisor) in the Medicaid Fraud Control Division. This position is located in Spokane, Washington. This position is represented by the Washington Federation of State Employees (WFSE).

This recruitment announcement may be used to fill multiple open positions for the same classification, in addition to the position(s) listed in this announcement.

The work of the Office’s Medicaid Fraud Control Division (MFCD) focuses on both criminal and civil law enforcement. The 75% federally funded MFCD’s mission is combating provider fraud, abuse and neglect in residential facilities and involving Medicaid recipients in non-institutional settings.

MFCD’s Headquarters is located in Olympia, Washington with some team members also located at the AGO’s Spokane Office and Seattle Office. The Division currently has a staff of 58 FTEs, including attorneys, auditors, Special Agents, data analysts and professional support staff.

MFCD involves protecting not only the Medicaid program of roughly 13 billion dollars per annum, but also its most vulnerable persons, typically elderly nursing home patients and Medicaid recipients in any setting. In many of our cases, there is no precedent so MFCD is consistently on the cutting edge of legal theories and issues. The cases range from abuse and neglect of persons in nursing homes, large scale organized individual and corporate civil and criminal fraudulent activity to national whistleblower actions. Our staff is a highly professional, fun and seasoned analytical investigative team. MFCD is unique in that all cases have an attorney, special agent, data analyst assigned with legal support. This, and the great people who make up the unit, gives MFC a particularly terrific team atmosphere.This is an expert level position that is responsible for investigating and coordinating highly complex civil and criminal healthcare fraud cases which are of a serious or sensitive nature which are assigned at the highest levels within the AGO under the oversight of the assigned AAG. The matters range from abuse and neglect in a residential facility to National Medicaid Fraud Control Unit (NAMFCU) national matters. This position carries a case load, creates investigative plans and participates as a team member on assigned cases.

Works with and oversees the work of others working with federal, local and Washington State law enforcement agencies as required under 42 USC 1396(b)(q)(4), 42 USC 1007.11 and 77 FR 32645. Act as MFCU Lead in multi-jurisdictional investigations relating to Medicaid provider fraud, abuse and neglect of vulnerable adults. Brings together partner agencies, develops case investigation plans, delegates duties as appropriate and follows up to ensure completion of assignments.

The incumbent: develops sources of information relating to Medicaid fraud and abuse and neglect in residential facilities; executes search warrants; collects, preserves and handles evidence in accordance with established rules of evidence; conducts surveillance; conducts criminal and civil interviews; prepares written reports, affidavits and other investigative documents; serves as a subject matter expert in civil and criminal healthcare fraud investigations.

Coordinates investigative activities with other Special Agents and Supervisors. Assigns and/or coordinates work and tasks assigned to Special Agents. Act as “Catching Agent” for the complaints Intake Process and act as one of four Back-up Catching Agents.

Review and edit supervised Special Agent’s work product. Provide guidance to Special Agents relating to healthcare fraud as well as abuse and neglect investigative practices, activities and actions.

Identify training needs of staff assigned to that team and relay those needs to the Special Agent in Charge as well as the respective Section Chief.

Facilitate team meetings designed to ensure safe, efficient and timely investigative strategies and activities are developed, implemented, and communicated routinely with other team members: Assistant Attorneys General, the Data Analyst.

Review and approve personnel leave requests made by Special Agents this position supervises. Complete personnel evaluations in accordance with AGO policy and guidelines.

This position will serve as a liaison agent, coordinating with local, state and federal law enforcement, industry partners and stakeholders, community organizations and the U.S. Attorney’s Office in matters relating to both routine and sensitive topics. In this capacity, the position is tasked with ensuring these relationships are maintained to the level that a seamless dialog can occur with these entities by other MFC staff, including, but not limited to, the Director, Civil and Criminal Section Chief, and Special Agent in Charge.

Bachelor’s degree and ten years of experience conducting investigations, which include the authority to independently plan and conduct investigations in civil or criminal cases. At least two of these years must include supervision of investigators.

Additional qualifying investigative experience may substitute year for year for education.

OR

Five years’ experience as an AGO Senior Investigator/Analyst.
APPLICATION INSTRUCTIONS

In addition to completing the online application, applicants must attach the following documents to their profile in order to be considered for this position:

A letter of interest, describing your specific qualifications for the position;
A current resume detailing experience and education.

For questions regarding this recruitment or assistance with the application process, please contact Judith Vandergeest at (360) 586-7691 or Judith.Vandergeest@atg.wa.gov.

If you are having technical difficulties creating, accessing or completing your application, please call NEOGOV toll-free at (855) 524-5627 or support@neogov.com.

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Posted on March 19, 2021 by MM_ADMIN

Medicaid Eligibility Representative

Description:

Full-time Position

Hours: 8:00am-4:30pm Monday through Friday at University Cleveland Medical Center. You will also work some holidays.

Hospital Referral Services has an opening at University Cleveland Medical Center and we are looking for self-motivated professional to add to our growing team. If helping people is something you enjoy, this may be the right job for you.

No one wakes up in the morning and says, “Today I want to go to the hospital”. We are here to help when the unexpected happens. Hospital Referral Services on-sites screen and help patient’s bedside to see what assistance programs the uninsured or underinsured may be eligible to receive.

HRS’s team of experts helps guide patients through the Medicaid process so the patient can focus on recovery.

We are looking to hire On-site Medicaid representatives starting immediately!

We offer great benefits such as Medical, Dental, Vision, Life Insurance, 401k, PTO, potential monthly Bonus and more!

. Requirements:

Job Duties and Responsibilities:

• Review the hospital work queue or census to identify uninsured patients.

• Screen/Interview patient’s bedside in hospital setting to determine possible eligibility for any assistance programs available including Medicaid and charity.

• High volume of walking and standing. (70% – 80% of your shift)

o Average amount of walking is 3 miles a day.

• Complete applications for Medicaid benefits and charity programs as needed.

• Maintain a positive working relationship with co-workers, hospital staff, and patients.

• Abide by HIPAA rules and regulations to protect patient’s privacy.

• Meet production goals and objectives as assigned by hospital and management on a monthly basis.

• Maintain confidentiality of account information at all times.

Requirements:

• Previous customer service experience preferred.

• Must have basic computer skills.

• Must be able to multitask and type minimum 40 WPM (a typing test will be conducted).

• Must have reliable transportation.

• Good attendance and dependability is essential.

• Successful completion of drug and background test is required.

• Annual Flu shots and TB testing is required.

• Availability to work alternating weekends and some holidays.

• $15 hour with bonus potential after 90 days – ($0-$325 for bonuses)

Please apply at: revenuegroup.com/careers

Apply for: On-Site Hospital Representative-Cleveland

Clipped from: https://remotefulltimejobs.com/jobs-near-me/medicaid-eligibility-representative-cleveland-ohio/247844170-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on March 19, 2021 by MM_ADMIN

Business Development – CMS/Centers Medicare and Medicaid Job Maryland USA,Business jobs

Position: Business Development Professional – CMS (Centers for Medicare and Medicaid)

Location: Windsor Mill

Description

Job Description:

Leidos is seeking a Business Development Professional to lead the business development and capture activities within our Centers for Medicare & Medicaid (CMS) portfolio. This position location is in the Baltimore, MD area with local and extended travel expected up to 10% of the time. The position is focused on identifying, qualifying, and capturing opportunities within CMS programs, continuing to build the Leidos reputation and business pipeline, executing the BD process, maintaining a high win probability, and growing business within the CMS domain.

Primary Responsibilities:

Proactively identify new business opportunities. Perform market research to qualify new business opportunities, including analysis of customer budgets, capabilities required, current customer preferences, competitive environment assessments, and incumbent strengths and weaknesses.
Coordinate and conduct meetings with customers, competitors, clients, and teammates to develop market insight on requirements, acquisition strategy, acquisition timing, and contract vehicle choices.
Work with program and management team in call plan development and execution, and provide detailed reports on follow up activities after plan execution.
Serve as Capture Manager for selected opportunities, either all the way to award or in the early capture phase.
Participate as required in the Leidos business development process, including pipeline reviews, opportunity gate reviews, black hat sessions, and proposal reviews.
Collaborate with Leidos Account Managers, IDIQ PMs, other BD personnel and capture and line management to support cross enterprise objectives and customer engagement.
Support overall strategic planning and linking pursuits/capture activities which support the business development metrics for awards, submits, and pipeline.
Interact routinely with various levels of management, functional leads, other staff, and customers.
Brief business development status to senior management when material changes occur and as required by the Leidos business development process.

Basic Qualifications:

Bachelor’s degree and 12-15 years of prior relevant experience.
Proven track record of successful business development at a variety of acquisition sizes.
Demonstrated access to and relationships with key CMS CMMI and CCSQ customers and industry partners.
Excellent written and verbal communication skills are essential.
Leadership skills to develop, organize and execute significant BD activities, including building industry teams, assessing win probability, and executing customer call plans.
Prior experience supporting business development and capture efforts for CMS agencies.
Strong, respected relationships within the CMS community
Ability to gain internal support, operate independently with limited supervision and feedback, and establish a solid working relationship with technical staff, division managers, and peers in the Group and across Leidos.
Self-starter and ability to manage time independently without direct supervision.
The ability to operate at the senior level and influence, negotiate and close.
Candidates must be US Citizens and be eligible to obtain a security clearance.

Preferred Qualifications:

A technical degree is highly desired
Proximity to CMS Baltimore location desired, but not required

External Referral Bonus: Eligible Potential for Telework: Yes, 10% Clearance Level Required: None Travel: Yes, 10% of the time Scheduled Weekly Hours: 40 Shift: Day Requisition Category: Professional Job Family: Business Development Pay Range:

Leidos is a Fortune 500 ® information technology, engineering, and science solutions and services leader working to solve the world’s toughest challenges in the defense, intelligence, homeland security, civil, and health markets. The company’s 38,000 employees support vital missions for government and commercial customers. Headquartered in Reston, Va., Leidos reported annual revenues of approximately $11.09 billion for the fiscal year ended January 3, 2020. For more information, visit .

Pay and benefits are fundamental to any career decision. That’s why we craft compensation packages that reflect the importance of the work we do for our customers. Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement. More details are available here .

Clipped from: https://www.learn4good.com/jobs/maryland/business/248360090/e/

Posted on March 19, 2021 by MM_ADMIN

Finance Director-Government Business Division, Mississippi Medicaid at Anthem Career Site – Tarta.ai

Description

SHIFT: Day Job

SCHEDULE: Full-time

The Government Business Division Finance Director is responsible for financial leadership, decision support, and strategic consultation to the leadership team in the Health Plan. This role directs health plan trend analysis, cost of care, financial reporting and analysis, financial operations, cost and budget management and administrative allocations in the Mississippi Medicaid Health Plan, and serves as a key liaison and subject matter expert with our state customer on medical trends, financial/reimbursement policy, payment mechanisms and financial implications of program and benefit changes.

Primary duties may include, but are not limited to:

Health plan P&L owner along with plan president and other functional leaders.

Serves as key health plan leader providing financial and strategic insight to other health plan functional areas; operates as a liaison with state partners; leads reimbursement management and negotiation; owns the Medical Cost Trend, cost of care process for plan and mitigation initiatives; and reviews financial statements, reserve development and financial analytics.

Partners with pricing actuaries to ensure that premium reimbursement is adequate to cover medical trends, administrative expenses and profit.

Reviews, analyzes, and presents financial results to health plan and line of business leadership as well as the board of directors.

Provides decision support for health plan leadership team for operational and business goals.

Directs health )

Achieves Medical Cost, MLR and operational income targets set in forecasts; ensures that provider network contracting obtains optimal financial arrangements; co-develops the setting of Cost of Care (CoC) targets and is responsible for CoC execution.

Directly interfaces with regulatory and audit personnel and technical consultants as required to ensure fiscal accountability.

Qualifications

Requires a BS/BA in Finance, Business Administration, or Accounting; 8-10 years of progressive financial experience with strategic and tactical planning, medical trend or business analytics, budgeting/forecasting, and accounting or financial reporting within a health insurance or managed care environment; experience with complex business environments and highly regulated situations; or any combination of education and experience, which would provide an equivalent background.

MBA preferred.

Clipped from: https://tarta.ai/j/TqKVQXgBrJRKg1c1Rk2w-finance-director-government-business-division-mississippi-medicaid-in-jackson-ms-at-anthem-career-site?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on March 19, 2021 by MM_ADMIN

LCMC Health Sr. CBO Specialist – Out Of State/Medicaid Program Job in New Orleans, LA | Glassdoor

POSITION SUMMARY:

This role is responsible to ensure out of state Medicaid enrollment documents are complete and submitted to ensure reimbursement for our hospitals and to maintain the re-enrollment cadence, when appropriate. In addition, this position is the subject matter expert on each state’s enrollment and billing requirements and performs analysis of the state’s provider manuals to ensure accurate and timely creation of claims within the revenue cycle billing platforms to ensure timely and accurate electronic billing. Works closely with other revenue cycle work stream leaders and will provide assistance and education to the collection and denial team members to recover reimbursement in a timely manner. This position will facilitate all responsibilities related to out of state Medicaid enrollment, billing and education and ensure that all patient/customer interactions meet LCMC’s goals vision and standards.

This job description is intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. LCMC Health reserves the right to amend and change responsibilities to meet organizational needs as necessary.

JOB SPECIFICATIONS:

Education:

Minimum Required: High School Diploma

Preferred: Undergraduate Degree

Experience:

Minimum Required: Two years of Revenue Cycle operations experience to include billing or collections.

Preferred: Specialized focus on Medicaid or Managed Medicaid third party payer billing and/or collection interactions. Prior experience with submission of provider enrollment applications is a plus.

Special Skills/Training:

Minimum Required: Excellent problem-solving skills, ability to create and maintain Excel spreadsheets, knowledge of billing and collection procedures.

Preferred: Medicaid credentialing, billing and/or collection experience preferred. Previous interaction via payer meetings experience highly desirable. Ability to research and formulate plan to ensure provider enrollment and work closely with IT and Billing leaders to devise claim form requirement to ensure reimbursement electronically and assist cash posting team with 837/835 electronic files.

POSITION DUTIES:

Out of State Medicaid Expertise

Develop comprehensive knowledge of OOS Medicaid program application process based on individual state requirements and coordinate inventory and timeline for enrollment applications and billing templates.

Out of State Medicaid Credentialing Process

Maintain each entity’s credentialing documents necessary to apply for a participating provider number.

Organization and Development Skills

Devise certification cadence to ensure provider numbers remain active.

Facilitate Epic Build & Maintance

Maintain expertise related to billing and collection for each OOS Medicaid plan and facilitate the claim billed in EPIC to ensure LCMC claims submission meets the OOS Medicaid requirements.

Out of State Medicaid Billing & Collection of AR

Responsible for OOS Medicaid collection of A/R and the accurate creation of Epic payer plans and billing templates to allow for accurate electronic billing and facilitation of electronic remittance processes.

LCMC Health is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status or any other characteristic protected by law.

Clipped from: https://www.glassdoor.com/job-listing/sr-cbo-specialist-out-of-state-medicaid-program-lcmc-health-JV_IC1150035_KO0,47_KE48,59.htm?jl=3664623177&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on March 19, 2021 by MM_ADMIN

Business Analysts-healthcare/Medicaid Job in Atlanta, GA – The Xela Group, LLC

We are seeking Business Analysts for our healthcare client.

We are seeking healthcare/Medicaid Business Analysts for our client. Candidates should have experience and functional knowledge with Drug Rebate. Should also have InterChange system expereince.
Candidates should have client facing business knowledge to be able to engage in requirements discussions.

BA should have very good written and verbal communication skills. Will need to elicit, document and analyze requirements.

Typically, a Bachelor’s degree in technical or business discipline or equivalent experience and a minimum of 3 years of related experience.

Recommended skills

Business Analysis

Medicaid

Clipped from: https://www.careerbuilder.com/job/J335RJ78L3HZ8HNVDSQ?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Posted on March 19, 2021 by MM_ADMIN

MEDICAID PROGRAM MONITOR

Job Details

MEDICAID PROGRAM MONITOR

This listing closes on 3/22/2021 at 11:59 PM Central Time (US & Canada).

Salary $23.33 – $45.91 Hourly $4,044.00 – $7,958.00 Monthly

$4,044.00 – $7,958.00 Monthly

Location Baton Rouge, LA

Baton Rouge, LA

Job Type

Classified

Department

LDH-Medical Vendor Administration

Job Number

MVA/SAG/1989

Closing date and time

3/22/2021 at 11:59 PM Central Time (US & Canada)

Supplemental Information

Job Number: MVA/SAG/1989

This position is located within the Louisiana Department of Health l Medical Vendor Administration l Program Integrity l EBR Parish.

Cost Center: 0305-7104
Position Number(s): 50487284

This vacancy is being announced as a Classified position and may be filled either as a Probationary Appointment, Job Appointment or Promotional Appointment.

(Job Appointments are Temporary Appointments up to 48 months)

****REVIEW YOUR APPLICATION TO MAKE SURE IT IS CURRENT. Failure to provide your qualifying work experience may result in your application not being considered.****

There is no guarantee that everyone who applies to this posting will be interview. The hiring supervisor/manager has 90 days from the closing date of the announcement to make a hiring decision. Specific information about this job will be provided to you in the interview process, should you be selected.

No Civil Service test score is required in order to be considered for this vacancy.

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.*

For further information about this vacancy contact:
Sanaretha Gray @ Sanaretha.Gray@la.gov
LDH/HUMAN RESOURCES
P.O. BOX 4818 BATON ROUGE, LA 70821
225 342-6477

Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree plus three years of professional level experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.

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 may be substituted 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.

Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.

A master’s degree in the above fields will substitute for one year of the required experience.

A Juris Doctorate will substitute for one year of the required experience.

Graduate training with less than a Ph.D. will substitute for a maximum of one year of experience.

A Ph.D. in the above fields will substitute for two years of the required experience.

Advanced degrees will substitute for a maximum of two years of the required experience.

Job Concepts

Function of Work:
To perform advanced research, analyses, and/or policy management activities for Medicaid programs.

Level of Work:
Advanced.

Supervision Received:
Broad from a Medicaid Program Supervisor or above.

Supervision Exercised:
None.

Location of Work:
Department of Health and Hospitals, Medical Vendor Administration.

Job Distinctions:
Differs from Medicaid Program Specialist 2 by the presence of advanced research, analysis and policy management responsibility.

Differs from Medicaid Program Supervisor by the absence of supervisory responsibility.

Examples of Work

Conducts audits of eligibility enrollment applications; prepares reports on results of each audit.

Prepares, interprets and clarifies eligibility policies and procedures.

Revises rules, regulations, and procedures to meet changes in law or policy.

Compiles data and proposes budgets for subprogram studies and proposed legislation; determines programmatic impact and composes response for
fiscal statements and fiscal notes.

Reviews current and proposed state and federal regulations and/or revisions to those regulations for hospitals and home health providers.

Evaluates new and/or revised regulations to determine the impact to the state Medicaid program.

Reviews audits performed by the contracted auditor to determine compliance with federal and/or state policies and regulations, which affect allowable costs.

Coordinates compliance monitoring of Medicaid Application Centers statewide.

Receives, approves and schedules all requests for Application Center Representative training.

Advises and assists field staff in performing on-site monitoring reviews to ensure that the Application Centers adhere to federal, state and agency
rules and regulations.

Assist in negotiating contractual agreements between the Department of Health and Hospitals and the Application Centers.

Provides functional supervision over contract staff.

Monitors and evaluates training provided by contract staff.

Prepares the annual budget request utilizing the prescribed format and addendums issued by the Office of Planning and Budget. Prepares detailed analyses
and narratives supporting and/or justifying the request as submitted. Responds to requests for additional information and modifications to the budget during
the legislative approval process.

Trains staff of all Medical Vendor Administration sections in fiscal management, budget development and variance reporting.

Develops training module and provides essential guidance to managers regarding preparing accurate, pertinent and substantiated data.

Benefits

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