Clipped from: https://www.linkedin.com/jobs/view/senior-fellow-%E2%80%93-health-program-improvement-federal-medicaid-at-mathematica-3502587485/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Position Description

 
 

About Mathematica:

 
 

Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being around the world. We collaborate closely with public- and private-sector partners to translate big questions into deep insights that improve programs, refine strategies, and enhance understanding using data science and analytics. Our work yields actionable information to guide decisions in wide-ranging policy areas, from public health, Medicare, Medicaid/CHIP, qualified and commercial health plans to education, family support, nutrition, employment, and international development. Mathematica offers our employees competitive salaries, and a comprehensive benefits package, as well as the advantages of being 100 percent employee owned. As an employee stock owner, you will experience financial benefits of ESOP holdings that have increased in tandem with the company’s growth and financial strength. You will also be part of an independent, employee-owned firm that is able to define and further our mission and enhance our quality and accountability. Read more about our benefits here: https://www.mathematica.org/career-opportunities/benefits-at-a-glance.

 
 

Position Description

 
 

Mathematica is searching for a seasoned professional who is a recognized expert with experience leading research and/or operating the Medicaid and or CHIP program at the state or federal level. This person will bring expertise focused on Medicaid/CHIP policy and programs or developing analytic approaches to guide policy development and implementation. The successful candidate will join our Health division to play leadership roles in engagements for the Center for Medicaid and CHIP Services, Medicaid and CHIP Payment Access Commission, state Medicaid agencies, foundations and other clients.

 
 

We are looking for an individual who is interested in directing his/her/their experience into data driven improvement of the Medicaid/CHIP programs in service to the programs’ beneficiaries and to their position as an essential part of the U.S. health care system. This expertise would be directed at quality assurance, mentorship, leadership development and connecting Medicaid and CHIP thought leaders in client spaces or the healthcare ecosystem to our fast moving and dynamic federal Medicaid practice area of more than 200 staff supporting current and emerging work across several areas related to monitoring and improving Medicaid and CHIP programs.

 
 

The senior fellow may represent Mathematica externally at conferences, on technical expert panels, and/or as an expert witness; develop thought leadership that is based on evidence; lead technical teams as project director or subject matter expert; assure quality by performing rigorous reviews of technical proposals or final deliverables; and serve as mentor and senior advisor at Mathematica developing ways to engage staff and share knowledge.

 
 

We are seeking an individual with expertise in several domains which might include:

 
 

• Eligibility and enrollment policy and account transfers across Medicaid/CHIP, Medicare and the Marketplace;
  
• Technical assistance on delivery system reform, including value-based care, alternative provider payments and care delivery models, and supplemental payment streams including UPL, DSH and state directed payments;
  
• Subject matter expertise on Medicaid managed care programs, innovations in social determinants of health, and/or quality improvement in Medicaid/CHIP programs including behavioral health and substance use disorder treatment;
  
• Health equity or subject matter domain expertise in areas where equity is a crucial consideration such as maternal and infant health, CHIP, HCBS;
  
• Developing, testing, and supporting the collection of measures of delivery and quality of services for beneficiaries; and
  
• Designing data analytics to monitor and evaluate outcomes of innovative programs and policies
  

 
 

The federal Medicaid practice is one of six that comprise our Health Unit. The successful candidate will join our group of over 700 health policy professionals in the Unit, including staff with degrees in data analytics, public health, public policy, economics, behavioral or social sciences, and other relevant disciplines. We offer our employees a stimulating team-oriented work environment. We take pride in our employees and in their commitment to excellence. We encourage staff to collaborate in developing creative solutions to difficult problems. This collegial spirit has helped us earn our reputation for innovative and high-quality work.

 
 

Duties Of The Position

 
 

• Direct multidisciplinary teams to conduct research, technical assistance, implementation and monitoring projects on topics related to state and federal Medicaid and CHIP policy and data systems, and oversee all aspects of high-quality project delivery
  
• Engage with state and federal clients to understand the challenges they face and work collaboratively with them to develop innovative solutions
  
• Apply rigorous analytic thinking to the collection and interpretation of quantitative and qualitative data, including analysis of Medicaid and CHIP administrative data and site visits or telephone interviews with state and federal officials
  
• Direct business development efforts and lead proposals for new projects
  
• Author project reports, memos, technical assistance tools, issue briefs, and webinar presentations and represent Mathematica to policy and professional audiences
  
• Contribute to the growth, expertise, and institutional knowledge of staff working in the Medicaid and CHIP area, including active mentorship
  

 
 

Position Requirements

 
 

• Masters or doctoral degree, plus 20 years of experience, or the equivalent, in public policy, economics, behavioral or social sciences, public health, or other relevant disciplines with a substantial portion of that time related to some aspect of the Medicaid or CHIP program at the state or federal level
  
• Expertise in quantitative and/or qualitative methods and a broad understanding of health policy issues
  
• Excellent written and oral communication skills, including an ability to explain observations and findings to diverse stakeholder audiences including program administrators and policymakers
  
• Demonstrated ability to lead major engagements and coordinate the work of multidisciplinary teams, including collaborations with technology teams building solutions in service to policy needs
  
• Strong track record in mentorship and leadership development.
  

 
 

One of Mathematica’s core values is a deep commitment to diversity, equity, and inclusion. Our work is more robust because it is informed by a variety of diverse perspectives, and our mission to improve societal well-being is strengthened by a greater understanding of issues and challenges facing the populations we serve. Mathematica’s ongoing commitment to diversity and inclusion is woven into our everyday actions, policies, and practices.

 
 

Various federal agencies with whom we contract require that staff successfully undergo a background investigation or security clearance as a condition of working on a project. If you are assigned to such a project, you will be required to obtain the requisite security clearance.

 
 

Available Locations: Princeton, NJ; Washington, DC; Cambridge, MA; Woodlawn, MD; Ann Arbor, MI; Oakland, CA; Chicago, IL; Remote

 
 

This position offers an anticipated annual base salary range of $175,000 – $225,000 and is eligible for an annual discretionary bonus based on company and individual performance.

 
 

Available locations: Washington, DC; Princeton, NJ; Cambridge, MA; Woodlawn, MD; Chicago, IL; Ann Arbor, MI; Oakland, CA; Seattle, WA; Remote

 
 

In accordance with Executive Order 14042 and its implementing guidelines, all Mathematica employees must provide documentation that they have been fully vaccinated or obtain an accommodation through Human Resources by providing documentation from a licensed health care provider that they are unable to be vaccinated against COVID-19 because of a disability (which would include medical conditions) or provide an attestation that they are entitled to an accommodation because of a sincerely held religious belief, practice, or observance.

 
 

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

Clipped from: https://www.idealist.org/en/government-job/9c01513b418d4483bd173c8282950da6-medicaid-principal-policy-analysts-medicaid-and-chip-payment-and-access-commission-washington?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

The Medicaid and CHIP Payment and Access Commission (MACPAC) is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP).

MACPAC is seeking experienced analysts with subject matter expertise in various areas of Medicaid and CHIP policy to join the team and play a leadership role in the development of MACPAC’s research agenda. These senior members of the policy team will design, direct, and conduct rigorous research projects on Medicaid and CHIP topics and be responsible for leading a portfolio of work. Currently, we are looking to hire multiple principal analysts to expand our capabilities in Medicaid and CHIP behavioral health (including mental health and substance use disorder), long-term services and supports (LTSS) policy, and Medicaid managed care policy.

We are seeking candidates with prior experience in Medicaid or CHIP who also are:

·      skilled in conceptualizing, designing and leading policy analyses, including identifying important and timely policy questions, and marshaling evidence from multiple sources;

·      able to identify and assess Medicaid and CHIP policy levers for addressing concerns related to access, quality, and cost of care, and developing policy options;

·      able to effectively communicate orally and in writing, translating technical information into clear and concise information for lay audiences;

·      able to produce work that is objective and non-partisan;

·      able to balance multiple tasks and work under deadlines, both independently and in collaboration with other team members; and

·      willing to foster a culture of inclusivity and belonging.

A graduate degree in health policy, health services research, public policy, public health or other related field is desirable, plus at least seven years or more health policy or research experience or the equivalent.

 
 

Clipped from: https://humana.talentify.io/job/value-based-program-contract-writer-medicaid—humana-r-304241?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Humana

Apply with job updates

• Job Description
  

 
 

Req#: R-304241

Description

Humana Healthy Horizons is seeking a Value-Based Contract Writer (Value-Based Programs Lead) who will conduct all aspects of value-based payment (VBP) contracting including development, implementation, negotiation, and maintenance in alignment with segment strategy and goals. The Value-Based Contract Writer (Value-Based Programs Lead) requires in-depth understanding of VBP and the contracting process to support value-based programs.

Responsibilities

• Creates new contracts based on the VBP design and the business operational capabilities.
  
• Integrates contract changes as needed for existing VBP programs.
  
• Creates and oversees new contract approval process.
  
• Collaborates with cross-functional areas to understand and align on VBP programs.
  
• Communicates program overview including contract terms, payment structures, and payment rates to providers
  
• Assists with associate and provider educational materials.
  
• Negotiates program terms and analyzes financial impact of proposed terms.
  
• Manages repository of contracts and key contract terms to support VBP administration.
  
• Drives positive experiences and performance among participating providers.
  

  Required Qualifications
  

• Bachelor’s degree.
  
• 3 or more years of contracting experience for a healthcare company.
  
• 2 or more years of VBP contracting experience.
  
• Experience creating new contracts based on the VBP design and the business operational capabilities.
  
  
• Proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
  
• Experienced in negotiating managed care contracts with primary physician groups or other specialty providers.
  
• Proven contract preparation skills, with an in-depth knowledge of Medicaid VBP methodologies.
  
• Excellent written and verbal communication skills and experience presenting to varied audiences.
  
• Ability to manage multiple priorities in a fast-paced environment.
  
• Knowledge of Microsoft Office applications.
  

  Work at Home Requirements
  
  

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
  
• Satellite, cellular and microwave connection can be used only if approved by leadership.
  
• Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
  
• Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
  
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
  

  Preferred Qualifications
  

• Master’s Degree.
  
• Experience with ACO/Risk Contracting.
  

  Additional Information
  
  

• Workstyle: Remote
  
• Work Days & Hours: Monday – Friday; Eastern Standard Time (EST) with some flexibility.
  
• Travel: Up to 10% possibly outside of your state of residence.
  
• Vaccination Statement: Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.
  

  Interview Format
  
  

  As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
  

  If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
  

  If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
  

  Social Security Task
  

  Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.
  

  Scheduled Weekly Hours
  
  

  40
  

• About the company
  

 
 

Humana looks at every facet of your life and works with you to create a path to health that fits your unique needs

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Clipped from: https://www.monster.com/job-openings/a-r-medicaid-specialist-remote-potential-louisville-ky–1914d441-e627-4ac1-959c-540c13a47c43?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

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We are Hiring at UofL Health!

 
 

Location: 250 E. Liberty Street Louisville, KY 40202

(Potential of remote work after completion of training and/or previous experience is verified)

 
 

Shift: Days 

 
 

About Us

UofL Health is a fully integrated regional academic health system with seven hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehabilitation Institute and the Brown Cancer Center.

 
 

With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.

 
 

Our Mission

As an academic health care system, we will transform the health of the communities we serve through compassionate, innovative, patient-centered care.

 
 

Job Summary

This position requires thorough knowledge of the Uniformed Bill, Medicaid and Managed Medicaid billing, secondary deductible/coinsurance billing, and payer resources for follow up.   Performs all duties related to timely and efficient billing and follow-up.  Thorough understanding of Medicaid eligibility, benefits, determining primary payer, and covered benefits.

Responsibilities

• Monitor and resolve claims holding on discharged not final billed (DNFB) list.
  
• Ensure all claims are filed electronically except for some paper claims.
  
• Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
  
• Follow up on unpaid Medicaid and Managed Medicaid claims in a timely manner.
  
• High dollar accounts will have consistent follow up until the account has been resolved.
  
• Responsible for reviewing and understanding explanation of benefits/remittance advice.
  
• Ensure statements are generated for the patient responsibility amounts.
  
• Utilize insurance websites to view and resolve claims.
  
• Perform extensive account follow-up and provide analysis of problem accounts.
  
• Document all follow up efforts in a clear and concise manner into the AR system.
  
• Familiar with inpatient only procedure list and work with Revenue Cycle leadership to prevent denials
  
• Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account
  
• Ensure medical record requests are documented and submitted in a timely manner
  
• Identify and report all trends that may provide insight into payment challenges.
  
• Phone contact with patient, physician office, attorney, etc for additional information to process claims.
  
• Work assigned accounts as directed while reaching daily productivity goals.
  
• Complete tasks by deadline.
  
• Attend seminars as requested.
  
• Other duties as assigned.
  

Qualifications

MINIMUM EDUCATION & EXPERIENCE

• High School Diploma, or GED
  
• 1 year of patient registration, billing or equivalent experience
  
• Working knowledge of medical and insurance terms is desirable.
  

KNOWLEDGE, SKILLS, & ABILITIES

• Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
  
• Knowledge of general insurance requirements.
  
• Experience working directly with EOBs and contractual adjustments.
  
• General computer knowledge, working with electronic filing.
  
• Ability to communicate verbally/in writing with professionalism.
  
• Ability to meet productivity expectations.
  

Benefits & Perks• Competitive Pay & Benefits Options• Paid Vacation, Sick days, and Holidays• Free tuition to UofL for Part- and Full-time employees for Child/Spouse/Domestic Partner• 401K with Employer Match

 
 

#LI-DNI

Clipped from: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Atlanta-GA/DSNP-Community-Engagement-Executive–Atlanta-_R-303825?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Description

Are you passionate about working with the Medicare and Medicaid population? Are you looking for a role in leadership with the ability to help improve the lives of the member population most at risk? If so, we are looking for a licensed, highly motivated and self-driven individual to join our team. The DSNP Community Engagement Executive cultivates sales and engagement opportunities as well as awareness for Humana’s Dual Medicaid-Medicare products, clinical programs and community services. This position requires a strategic and independent thinker who can collaborate across multiple channels of the organization, including sales, operations, network and bold goal as well as external partners such as physicians, faith-based organizations and community groups. Humana has an inclusive and diverse culture welcoming candidates with multilingual skill sets to service our consumers.

Responsibilities

The DSNP Community Engagement Executive identifies and builds relationships with organizations and providers that serve the dual-eligible population; strategizes ways to make these opportunities reach members/prospects and help drive connections to Humana and our Dual Eligible-Special Needs Plans (DSNP) and services. This individual is also responsible for organizing meetings and forums to engage the dual-eligible population to create leads for the sales team. Other responsibilities include tracking events, leads generated, brokers engaged, community organizations partnered with, and methods of engaging and helping the dual eligible population. The DSNP Community Engagement Executive provides supplies, materials and educational items, prepares any necessary documentation, collaborates with and supports sales leadership and other departments as necessary. This role requires good analytical skills to identify growth areas to drive relationships, sales and retention while complying with all CMS guidelines.

Required Qualifications

• Active Georgia Health and Life Insurance licenses
  
• Prior experience in public speaking and conducting presentations
  
• Experience with technology to include high level use of laptop and mobile phone applications with an understanding of CRM tools or other sales/marketing resources
  
• This role is part of Humana’s Driver safety program and requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100/300/100 limits 
  

Preferred Qualifications

• Bachelor’s Degree
  
• Prior experience with proficiency in MS Office products
  
• Prior experience working in both Medicare and Medicaid
  
• Community Engagement/Grassroots experience in marketing Medicare plans in the community
  
• Prior leadership experience collaborating across multiple channels of a healthcare organization
  

Additional Information

• This position could require travel approximately 20% or more with some overnight stays
  
• Upon offer acceptance you must be able to complete and pass the AHIP certification (paid for by Humana) prior to your start date
  

Scheduled Weekly Hours

40

Clipped from: https://careers.benevis.com/jobs/5103?lang=en-us&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

CAROUSEL_PARAGRAPH

Overview

 

Benevis is a comprehensive practice services company committed to improving healthcare access by providing non-clinical, business support services to many of the nation’s leading healthcare organizations. Benevis provides support to dental offices throughout the U.S., including more than 120 practices. Our team members enjoy a fast-paced, fun and friendly work environment, built upon the organization’s culture: “Smile On, Our Smiles” which focuses on teamwork and collaboration, learning and growing, and celebrating our team and personal successes.

 
 

The Medicaid Coordinator provides support to the Medicaid Verification Lead in ensuring the support provided by the department to the field is timely and efficient. The ideal candidate is goal driven, detail oriented, self-motivated, able to multitask, and is able to communicate effectively and relate comfortably with people across levels and functions.

Responsibilities

 

ESSENTIAL JOB FUNCTIONS 

 
 

• Assist the Medicaid Verification Lead in optimizing the efficiency of the Central Verification Team; through building teamwork and encouraging excellence of service and enabling the offices to better serve our patients.
  
• Assist with the training of new Medicaid Verifiers.
  
• Assist in answering specific inquiries from the field offices and other departments.
  
• Assist with the distribution of daily assignments to the team
  
• Assist with quality audits
  
• Occasionally assist with interviews of new Medicaid Insurance Specialist candidates
  
• Support and provide coverage in absence of Medicaid Verification Lead
  

ADDITIONAL DUTIES AND RESPONSIBILITIES 

Assist with other office duties and projects to support the Medicaid Verification Lead as needed

Qualifications

 

REQUIRED QUALIFICATIONS

Minimum 2 years of experience in Medicaid Insurance verification, or Benevis Billing certification with a minimum of 1 year Medicaid Verification experience

Knowledge, Skills, Abilities and Personal Characteristics

• High School diploma or equivalent
  
• High focus on customer service and satisfaction
  
• Must enjoy working in a fast-paced environment
  
• Compassion and high level of service for our clients, internal and external
  
• Integrity, always doing the right thing
  
• Team building skills; organizational and staff development skills
  
• Strong interpersonal and communication skills
  
• Attention to detail
  
• Ability to work re-verifications and resolve COB issues
  

Clipped from: https://jobs.khon2.com/jobs/medicaid-quality-assurance-specialist-full-time-appleton-wisconsin/954429100-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Medicaid Quality Assurance Specialist-Full Time

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Medicaid Quality Assurance Specialist-Full Time

Salary

$21.50 – $22.67 Hourly

Location

Appleton, WI

Job Type

Full-time

Department

DHHS Mental Health

Job Number

Typical Work Hours/Shift:

Monday – Friday 8:00 AM to 4:30 PM, with possibilities of overtime

• Description
  
• Benefits
  
• Questions
  

Position Purpose

The Medicaid Quality Assurance Specialist reviews Medicaid related services within the Mental Health/Alcohol and Other Drug Abuse (MH/AODA) Division of the Department of Health and Human Services (DHHS) for the purposes of identifying client, staff and systems errors that may result in improper billings to third parties, incorrect benefits to clients, and sometimes, fraudulent activities (intentional program violations by the client, provider, or staff member). The Medicaid Quality Assurance Specialist also helps us train Division staff and contract providers to avoid Administrative Code errors, incorrect billings, and to ensure general quality assurance.

The hours for this role are:

Monday – Friday 8:00 AM to 4:30 PM, with possibilities of overtime

Key Responsibilities

The following duties are most critical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.

• Maintains knowledge of Federal and State rules, regulations and Administrative Codes that impact Medicaid.Trains MH/AODA Division staff to recognize and correct errors and ensure program compliance and accuracy.
  
• Performs Quality Assurance reviews on Division cases and contract provider records for compliance with Federal, State, and Division policies, procedures and Administrative Codes.Analyzes the results of reviews and works with MH/AODA Division staff on assisting with implementing corrective measures.
  
• Develops and maintains resources, networks with outside agencies and attends necessary training in order to maintain current knowledge of all rules and regulations enacted by Federal, State and local entities for Medicaid.
  
• Identifies and assists in developing improvement strategies for all of the MH/AODA Division Medicaid programs and monitors results of implementation of those improvement strategies.Ensures that a continuous improvement process is maintained in the MH/AODA Division for all Medicaid programs.
  
• Maintains regular and predictable attendance and maintains all necessary documentation and evidence in compliance with audit and statutory requirements.
  
• Effectively facilitates meetings with leadership, management, and staff on the analysis of performance including:identification of challenges, achievement, and compliance with established guidelines and best practice standards.
  
• Participates actively and effectively in development activities such as conference calls, professional meetings to include MH/AODA and Fiscal related Statewide and Regional meetings.
  
• Completes and maintains necessary documentation and reports according to applicable requirements, Codes and policies.
  

Education/Certifications/Experience Requirements

• Bachelor’s degree in a human services related field.
  
• Two years’ experience in direct practice with individuals with a range of mental health and/or substance abuse diagnoses.
  
• Experience in MH/AODA service facilitation and MH/AODA Administrative Codes.
  
• Experience in Quality Assurance practice.
  
• Case Management experience.
  

Required or Preferred Skills

• Displays a high level of initiative, effort and commitment towards completing assignments efficiently and accurately.Works well in independent project development and adapts easily to multiple projects, assignments, and deadlines.
  
• Effective interpersonal skills, communication skills, and a flexible approach.
  
• Ability to attend staffings and other meetings as needed.
  
• Ability to maintain confidential information, including worker performance.
  
• Valid Wisconsin Driver’s License.
  

OUTAGAMIE COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER. IN COMPLIANCE WITH THE AMERICANS WITH DISABILITIES ACT, THE COUNTY WILL PROVIDE REASONABLE ACCOMMODATIONS TO QUALIFIED INDIVIDUALS WITH DISABILITIES AND ENCOURAGES BOTH PROSPECTIVE EMPLOYEES AND INCUMBENTS TO DISCUSS POTENTIAL ACCOMMODATIONS WITH THE EMPLOYER.

Clipped from: https://www.ziprecruiter.com/c/Oak-Street-Health/Job/Medicaid-Specialist/-in-Carolina,SC?jid=17bb695d5a113466&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 Company: Oak Street Health

Title: Patient Relations Manager, Medicaid Specialist

Location: Location flexible, prefer IL, IN, PA, MI, TX, NY

Role Description:

Oak Street Health takes a team-based approach to providing outstanding patient care. Patient Relations Managers (PRMs) – Medicaid Specialists are an integral part of our team and sit within our Contact Center team. They place outgoing and receive incoming calls or referrals in an effort to support our low-income eligible patients with assessing and applying for Medicaid. Medicaid helps patients save money on healthcare expenses, thus improving their access to care. PRMs – Medicaid Specialists advocate for our patients by helping them navigate low-income and insurance resources available. They are also a resource to our center teams for questions regarding Medicaid and eligibility. During the upcoming Medicaid redetermination period PRMs – Medicaid Specialists will be integral in helping our patients navigate the state-specific redetermination process to maintain coverage and continuity of care.

 
 

Core Responsibilities:

• Place outgoing and receive incoming calls or referrals to assist patients in the Medicaid redetermination process and eligibility and application process
  
• When applicable, attend Medicaid redetermination events in person to support patients application and renewals
  
• Learn the ins and outs of Medicaid and use knowledge to assist patients with navigating low-income resources available
  
• Serve as internal resource for all teams on Medicaid questions
  
• Advocate for the patient in what resources they are entitled to
  
• Gain the trust of Oak Street Health patients in an effort to properly advise them in their healthcare coverage 
  
• Effectively communicate and coordinate across teams to ensure patient needs are met
  
• Provide exceptional customer service
  
• Other duties, as assigned
  

 
 

What are we looking for?

• Sales background preferred, but not required
  
• Prior Medicaid experience preferred, but not required
  
• Familiarity with relevant patient population
  
• Community health experience preferred
  
• Proficient PC skills
  
• Bachelor’s degree preferred, or equivalent experience
  
• Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve, where necessary
  
• US work authorization
  
• Someone who embodies being “Oaky”
  

What does being “Oaky” look like?

• Radiating positive energy
  
• Assuming good intentions
  
• Creating an unmatched patient experience
  
• Driving clinical excellence
  
• Taking ownership and delivering results
  
• Being relentlessly determined
  

Why Oak Street Health?

Oak Street Health is on a mission to “Rebuild healthcare as it should be”, providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient’s communities, and focused on the quality of care over volume of services. We’re an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody “Oaky” values and passion for our mission.

Oak Street Health Benefits: 

• Mission-focused career impacting change and measurably improving health outcomes for medicare patients
  
• Paid vacation, sick time, and investment/retirement 401K match options
  
• Health insurance, vision, and dental benefits
  
• Opportunities for leadership development and continuing education stipends
  
• New centers and flexible work environments
  
• Opportunities for high levels of responsibility and rapid advancement
  

 
 

Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. 

Learn more at www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health 

Clipped from: https://us.jora.com/job/Medicaid-RFP-Development-Director-9aea53d5624f7e38ab0a944701cdc7a4?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Position Title:

Medicaid RFP Development Director

Job Description:

Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Medicaid RFP Development Director is responsible for developing a comprehensive functional area market capture plans, built on deep market knowledge, trends and intelligence resulting competitive solutions and best-practices that meet state-specific needs and goals. 
Primary duties may include, but are not limited to:
•Drives and facilitates the development and delivery of market-specific solutions, capabilities, partnerships, and innovations that strengthen competitive advantage and readiness for a health plans upcoming procurement. 
•Builds, promotes, and secures agreement on the bid strategy; monitors, evaluates, and escalates the delivery of the strategy or given risks for the capture plan for the functional area. 
•Accountable for translating the capture strategy to the proposal team to ensure its accurately represented and compelling to proposal evaluators; this includes providing significant input on assigned proposal sections, response messaging, content, and solutions throughout executive team reviews.
Qualifications:
•Requires a BA/BS degree in business, public health, nursing, medicine, health care delivery, or a related field and a minimum of 7 years work related experience in Medicaid business and a minimum of 5 years of experience leading cross functional teams; or any combination of education and experience, which would provide an equivalent background.

Job Level:

Director Equivalent

Workshift:

Job Family:

BUS > Business Dev/Growth

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact *******@icareerhelp.com for assistance.

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact *******@icareerhelp.com for assistance.

Clipped from: https://www.linkedin.com/jobs/view/managing-consultant-%E2%80%93-medicaid-solutions-management-and-operations-at-mathematica-3537829375/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Position Description

 
 

Mathematica applies expertise at the intersection of data, methods, policy, and practice to improve well-being around the world. We collaborate closely with public- and private-sector partners to translate big questions into deep insights that improve programs, refine strategies, and enhance understanding using data science and analytics. Our work yields actionable information to guide decisions in wide-ranging policy areas, from health, education, early childhood, and family support to nutrition, employment, disability, and international development. Mathematica offers our employees competitive salaries, and a comprehensive benefits package, as well as the advantages of being 100 percent employee owned. As an employee stock owner, you will experience financial benefits of ESOP holdings that have increased in tandem with the company’s growth and financial strength. You will also be part of an independent, employee-owned firm that is able to define and further our mission, enhance our quality and accountability, and steadily grow our financial strength. Learn more about our benefits here.

 
 

Mathematica is searching for a self-motivated professional with a passion for solving clients’ pressing problems and improving operations, and a strong interest in our Medicaid project area. Managing consultants often work on more than one project at a time and are matched with projects that align with their interests and skills. In particular, we are looking for individuals who can support current and emerging work across any number of areas related to monitoring and improving Medicaid programs such as: Medicaid managed care programs, value-based purchasing and alternative payment models, long-term services and supports, measures of delivery and quality of services for beneficiaries, data analytics, and outcomes of innovative programs and policies. Managing consultants participate in and lead a range of tasks at Mathematica, from overseeing small teams or managing projects, to developing solutions for some of our clients’ most challenging problems. While the duties of the position vary depending on project assignments, most managing consultants serve in roles that require a blend of policy expertise and management skills. This may include:

 
 

• Serving as task leaders, project managers, or deputy project directors on complex, fast-paced projects focused on Medicaid policy, oversight, and program operations
  
• Developing and maintaining project schedules, staffing plans, and budgets
  
• Collaborating with federal, state, and other clients and entities to develop and implement quality improvement strategies or technical assistance plans based on available data and subject matter expertise
  
• Planning and executing of webinars or small group discussions with government clients, healthcare payers, and/or other entities and individuals
  
• Managing diverse perspectives and thinking creatively to design solutions that meet client needs
  
• Authoring memos, standard operating procedures, data dictionaries, implementation guides, webinar slides, and other technical assistance tools to facilitate program improvement
  
• Providing the energy, direction, organization, and quality control needed to help keep projects on time and on budget and to facilitate communications across and between internal and external stakeholders
  

 
 

Position Requirements

 
 

• Master’s degree in public policy, public administration, public health, healthcare administration, business, or a related field; or equivalent experience
  
• Five or more years of experience managing complex projects or tasks related to healthcare or health policy.
  
• Experience working at or with a state or federal agency, a foundation, a healthcare provider, or another policy research firm is highly desirable.
  
• Demonstrated ability to lead activities, manage tasks through the project lifecycle, and coordinate the work of multidisciplinary teams to deliver high-quality work to our clients on time and budget
  
• Strong analytic skills and ability to think critically about issues relating to management, such as financial analysis, as well as policy implementation and program operations.
  
• Excellent written and oral communication skills, including an ability to explain observations and findings to diverse stakeholder audiences including program administrators and policymakers
  
• Strong organizational skills and high level of attention to detail as well as the flexibility to manage multiple priorities, sometimes simultaneously, under deadlines
  
• Strong mentorship skills to mentor early career staff members
  
• Familiarity with agile project management tools and techniques (e.g., JIRA, scrum) is a plus; Project Management Professionals (PMPs) also encouraged to apply.
  
• Familiarity with human-centered design principles and/or quality improvement approaches (Lean Six-Sigma, PDSA cycles) is also desirable.
  
• Knowledge and experience with Medicaid or Health Insurance Marketplace managed through healthcare.gov is a plus
  

 
 

Please submit a cover letter, CV and work product that demonstrates your analytic abilities as well as your understanding of complex policy-related challenges facing the healthcare system.

 
 

This position offers an anticipated annual base salary of $90,000-$130,000. This position may be eligible for a discretionary bonus based on company and individual performance.

 
 

Various federal agencies with whom we contract require that staff successfully undergo a background investigation or security clearances a condition of working on projects. If you work on such a project, you will be required to obtain the requisite security clearance.

 
 

Available Locations: Ann Arbor, MI; Cambridge, MA; Princeton, NJ; Oakland, CA; Washington, DC; Chicago, IL; Seattle, WA; Woodlawn, MD; Remote

 
 

Candidates who are interested in working remotely are invited to apply.

 
 

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.