Category: Curator- Job Hunter

 
 

Job Description

Description

The Lead, Medicaid Technology Product Enablement devises an effective strategy for executing and delivering on IT business initiatives. The Lead, Medicaid Technology Product Enablement requires a solid understanding of how organization capabilities interrelate across department(s).

The Lead, Medicaid Technology Product Enablement collaborates with the business and functional stakeholders to identify and deliver strategic enablement solutions that support profitable Medicaid business growth. Decisions are typically related to identifying and resolving complex technical and operational problems within department(s), and could lead multiple managers or highly specialized professional associates. Understands department, segment, and organizational strategy and operating objectives. Makes decisions regarding own work methods, often in ambiguous situations, and requires minimal direction, receiving guidance where needed. Able to prioritize and deliver multiple tasks with tight timelines. Acts as a change agent with an agile mindset to quickly pivot based on evolving information in a highly ambiguous environment. Builds and maintains partnership with key stakeholders. Possesses excellent written and verbal communication and presentation skills. Demonstrates a high level of executive presence and leadership skills. Able to communicate with high level of business acumen. Able to thrive in a fast-paced, growth-oriented environment

Responsibilities

Duties may include, but are not limited to, the following:

• Develop solutions based on our consumer journey to meet our members where they are
  
• Drive work from concept to implementation across multiple teams – both business and development
  
• Enhance the consumer experience with intelligent solution design and execution
  
• Oversees team to ensure complete requirements meet the state contracts and exceed the member expectation
  
• Organize delivery in small executable blocks of work
  
• Partner with the business teams to drive priority
  
• Empower a team of professional employees to own value chains and stream dependencies between systems, identify synergies, and reduce risk to implementation timelines
  
• Engage in solution design session with Medicaid architects and individual system architects to identify solutions that will support Medicaid growth
  
• Support Medicaid CIOs by identifying and offering cross market opportunities
  
• Reduce silos between systems and business processes
  
• Propose opportunities for system enhancements and innovation to better meet consumer needs
  
• Own relationship with vendor an internal supported solutions
  
• Engage in contract negotiations and development of statement(s) of work with external vendors
  
• Document consumer journey map to technical solutions
  
• Builds strategic partnerships and manages relationships between IT and the aligned business group leaders
  
• Obtain and synthesize complex data to tell value stories by product
  
• Serves as trusted leader and partner to deliver high quality products
  
• Champions culture change, process improvement, and drives adoption of agile ways of working
  

Required Qualifications :

• Bachelor’s Degree
  
• 6 or more years of technical experience
  
• 2 or more years of management experience
  
• Solid understanding of operations, technology, communications and processes
  
• Possess 10+ years of progressive experience leading continuous improvement efforts, evaluating existing systems and implementing process improvements.
  
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  
• Ability to manage multiple tasks and deadlines with attention to detail
  
• Ability to communicate effectively and deliver presentations to senior leaders
  
• Proven experience organizing and directing multiple teams and departments
  
• Excellent communicator in written and verbal form
  
• Extremely versatile, dedicated to efficient productivity
  
• Experience planning and leading strategic initiatives
  
• Proficient with full Microsoft Office suite, Microsoft Visio, Microsoft Teams
  

Preferred Qualifications :

• Master’s Degree
  
• Experience in Medicaid
  
• Experience in Product Management
  
• Strong understanding of regulatory and compliance metrics
  
• Knowledge of/Certification in SAFe Agile methodology
  
• Consulting experience with a focus on operations management
  
• Proven success in a project/program management role
  
• Nimble business mind with a focus on developing creative solutions
  
• Strong reporting skills, with a focus on interdepartmental communication
  

Additional Information

For this job, associates are required to be fully COVID vaccinated (preferred) or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.

If progressed to offer, you will be required to:

• Provide proof of full vaccination or commit to testing protocols *OR  *
  
• Provide proof of applicable exemption including any required supporting documentation
  

Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

40

 
 

Clipped from: https://lensa.com/product-strategy-medicaid-technology-remote-jobs/birmingham/jd/db4fba2ce94d1deee02ec1e05e069cdf?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

MEDICAID PROGRAM MANAGER 1–B

This listing closes on 8/30/2022 at 11:59 PM Central Time (US & Canada).

Salary

$4,954.00 – $9,748.00 Monthly

Location

Baton Rouge, LA

Job Type

Classified

Department

LDH-Medical Vendor Administration

Job Number

MVA/SAG/161352

Closing date and time

8/30/2022 at 11:59 PM Central Time (US & Canada)

• Description
  
• Benefits
  

Supplemental Information

 
 

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Program Operations and Compliance / EBR Parish.
 
  Announcement Number:  MVA/SAG/161352
  Cost Center:  305-2020600
  Position Number(s):  171572
 
This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary or Promotional appointment.
 
(Job appointments are temporary appointments that may last up to 48 months)
  
  
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.*
  
A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit
 
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.
 
For further information about this vacancy contact:
Sanaretha Gray
Sanaretha.Gray@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
225 342-6477
 
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218. 

Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree plus four years of professional 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; public relations; 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 the required 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.

 
 

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.

Job Concepts

Function of Work:
To administer small and less complex statewide Medicaid program(s).

Level of Work:
Manager.

Supervision Received:
Broad from a higher-level manager/administrator.

Supervision Exercised:
Supervision over lower-level position(s) in accordance with the Civil Service Allocation Criteria Memo.

Location of Work:
Department of Health and Hospitals.

Job Distinctions:
Differs from Medicaid Program Monitor by responsibility for administering small and less complex statewide program(s) and supervision exercised.

Differs from Medicaid Program Manager 1-A by the presence of supervisory responsibility.

Differs from Medicaid Program Manager 2 by the absence of responsibility for administering medium size or moderately complex statewide program(s) and supervision exercised.

Examples of Work

Supervises the auditing of eligibility enrollment of all Medicaid programs statewide.

Reviews work of eligibility review staff for quality assurance.

Plans, coordinates, and controls a small or less complex statewide program.

Plans, develops, implements and monitors comprehensive Medicaid program policies.

Conducts and directs studies/special projects pertaining to the programs assigned.

Analyzes the impact of federal, state, and local legislation; advises agency officials; prepares position statements; presents testimony at hearings; writes legislation.

Reviews and analyzes complex data and system reports to ensure compliance with program regulations.

Administers the day-to-day operational functions of the Medicaid fee for service programs. Assures that program policy and procedures are properly applies in accordance with federal and state laws and regulations.

Develops and writes agency rules and regulations governing the administration of all supervised Medicaid programs and submit them for publishing in the official state publication in accordance with the requirements of the Administrative Procedures Act.

Implements Medicaid regulations directing provider participation standards and recipient benefits. Analyzes multi-mullion dollar Medicaid claim data and project the fiscal impact for budget forecasting.

Identifies, verifies and analyzes the various revenue sources for the program(s). Determines and/or confirms match requirements. Monitors availability of revenue sources and promptly identifies existing or potential financing problems.

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 https://info.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

Apply

Clipped from: https://www.governmentjobs.com/jobs/3680731-0/medicaid-program-manager-1-b?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

Job Details

 

 
 

 
 

Job Description

The Lead Director will be accountable for designing conceptual models, initiative planning, and negotiating high value/risk contracts with the most complex and challenging, market/region/national, largest group/system or highest value/volume of spend providers in accordance with company standards in order to maintain and enhance provider networks, while working cross functionally to ensure consistency with all contracting strategies and meeting and exceeding accessibility, quality, compliance, and financial goals and cost initiatives.

Drives or guides development of holistic solutions or strategic plans negotiates and executes contracts with the most complex, market/region/national, largest group/system or highest value/volume of spend

providers with significant financial implications. Manages contract performance, and drives the development and implementation of value based contract relationships in support of business strategies.

Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups. Collaborates cross-functionally to manage provider compensation

and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.

Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives. Represents company with high visibility constituents, including customers and community groups.

Promotes collaboration with internal partners. Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to

meet state contract and product requirements. Collaborates with internal partners to assess effectiveness of tactical plan in managing costs. May optimize interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met.

Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.

Pay Range

The typical pay range for this role is:

Minimum: 100,000

Maximum: 221,000

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications

Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements

and regulatory requirements.

Strong communication, critical thinking, problem resolution and interpersonal skills

Education

Bachelor’s Degree or equivalent combination of education and experience

Business Overview

Bring your heart to CVS Health

Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day.

CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

 
 

Clipped from: https://getwork.com/details/88de6b75c1d33cdf16d949b6faf95cbb?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Exciting opportunity to lead new government programs at an innovative, rapidly growing care management company that leverages technologyto meet human touch.

The Government Programs and Government Relations team leads the organizations growth efforts by engaging with States to promote and expand the services within identified markets.

Reporting to the SVP, New Program Development, the Director of Business Development for Government Programs partners with State leaders in Medicaid agencies to develop and implement comprehensive family caregiver support programs as Medicaid benefits. In collaboration with other team members, this individuals primary responsibilities will be to present the companys services to prospective clients and secure new State contracts.

Responsibilities:

• Research and analyze industry trends and environmental and competitive conditions generally and in identified markets
  
• Develop a strategic engagement plan for each identified State market that is consistent with company’s objectives and core values
  
• Implement engagement plans efficiently to assess client needs and facilitate alignment with Seniorlink services
  
• Establish and maintain trusted and productive relationships with potential clients throughout the business development cycle
  
• Identify and recommend additional potential client opportunities
  
• Develop and present reports to update leaders on progress, business learnings, and market trends
  

Qualifications:

• 10+ years experience in the healthcare industry in a business development or program development role; experience working within a Medicaid agency highly preferred.
  
• A working knowledge of Medicaid programs including delivery systems for long-term services and supports required
  
• Demonstrated ability to work independently, as a part of a small team, and in larger cross-functional project teams
  
• Excellent communication skills (verbal, written, and presentation)
  
• An entrepreneurial and optimistic mindset
  
• A Bachelors degree is required
  
• Ability to travel; travel will be planned and predictable
  

This is a 100% remote role with some travel. Competitive base salary, incentive bonus and benefits available.

 
 

Clipped from: https://www.startwire.com/jobs/birmingham-al/director-medicaid-program-4001711505?source=seo&utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

Description

The Manager, Compliance – Medicaid State Reporting ensures compliance with governmental requirements. The Manager, Compliance – Medicaid State Reporting works within specific guidelines and procedures; applies advanced technical knowledge to solve moderately complex problems; receives assignments in the form of objectives and determines approach, resources, schedules and goals.

How we Value You

Benefits starting day 1 of employment

Competitive 401k match

Generous Paid Time Off accrual

Tuition Reimbursement

Parent Leave

Go365 perks for well-being

Responsibilities

The Manager, Compliance – Medicaid State Reporting develops and implements compliance policies and procedures and researches compliance issues as they relate to reporting; recommends changes that assure compliance with contract obligations.

• Maintains relationships with Market compliance teams.
  
• Coordinates implementation of new Medicaid markets and compliance with corrective action plans, as needed.
  
• Decisions are typically related to resources, approach, and tactical operations for projects and initiatives involving Medicaid State Reporting.
  
• Requires cross departmental collaboration, and conducts briefings and area meetings; maintains frequent contact with other managers across the department.
  

Required Qualifications

• Bachelor’s Degree
  
• 2 or more years of people or project/process management leadership
  
• 5 or more years of Compliance experience
  
• Ability to work in a deadline-driven organization
  
• Comprehensive working knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
  
• Ability to manage multiple projects/assignments while working with various departments to obtain data
  
• Strong attention to detail
  
• Success in developing and managing working relationships within a highly matrixed business environment
  
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences
  

Preferred Qualifications

• Graduate or advanced degree
  
• Prior experience analyzing data and metrics to influence change in departmental processes
  
• Prior health insurance industry experience
  
• Experience in data visualization tools (Power BI, Tableau, etc.)
  
• Medicaid experience/knowledge
  

Additional Information

• Hours- CST or EST
  

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.

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
  
• A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.
  
• Satellite and Wireless Internet service is NOT allowed for this role.
  
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
  

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.

Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/yammer and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.

Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide their social security number, if it is not already on file. When required, an email will be sent from [ Email address blocked ] – Click here to apply to Manager, Compliance – Medicaid State Reporting with instructions on how to add the information into your official application on Humana’s secure website.

Scheduled Weekly Hours

40

Recommended Skills

• Attention To Detail
  
• Corrective And Preventive Action (Capa)
  
• Data Visualization
  
• Decision Making
  
• Leadership
  
• Medicaid
  

 
 

Clipped from: https://www.careerbuilder.com/job/J3P7536MB2S78RGCNKV?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description

Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:
Performs technical work in obtaining Medicaid/Social Security (SSI) insurance coverage for indigent patients to expedite reimbursement for medical services. Positions take the patient through the entire Medicaid application process from application to award or denial. Positions have authority to represent the Health Care System at each of the four levels of appeals when applications are denied.

Responsibilities:
1. Obtains detailed personal, financial and asset information to determine if patient qualifies for one of ten Medicaid/SSI programs. Completes or assists the patient with completion of Medicaid application. Explains the programs and advises patients of methods to become eligible by rearranging finances and assets. Follows through with applicants to obtain accurate and complete information within strict timeframes. Positions must have substantive knowledge of various rules and regulations governing the ten Medicaid programs. Interprets and applies frequent changes in program regulations to expedite applications.
2. Reviews denials from Medicaid/SSI and researches denial information with patients. Advocates for patient coverage with local and state Medicaid offices to obtain reversal of initial denial. Abstracts information, prepares appeals and represents UNC Health Care System in appeal hearings at local, state (Division of Medical Assistance), Office of Administrative Hearings, and state court to present supportive evidence for patient’s denial reversal.

Other Information Education Requirements:
Associate’s degree in an appropriate discipline (or equivalent combination of education, training and experience).
Licensure/Certification Requirements:
No licensure or certification required.
Professional Experience Requirements:
If an Associate’s degree: Two (2) years of experience in a social services or healthcare organization.
If a High School diploma or GED: Four (4) years of experience in a social services or healthcare organization.
Knowledge/Skills/and Abilities Requirements:
Analytical, Customer Service, Direct Patient/Family Interaction/ Hospital/Healthcare Experience, Interpersonal, Report Preparation, Strong Written and Verbal Communication skills.

Job Details Legal Employer: STATE

Entity: Shared Services

Organization Unit: Medicaid Eligibility

Work Type: Full Time

Standard Hours Per Week: 40.00

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: No
 

 
 

Clipped from: https://jobs.cw33.com/jobs/eligibility-specialist-medicaid-eligibility-chapel-hill-north-carolina/683903875-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

List of Jobs and Events

 
 

Advisory Services/Project Management Analyst (Medicaid)

Mathematica Policy Research Princeton, NJ Full-Time

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. Read more about our benefits here: [ Link removed ] – Click here to apply to Advisory Services/Project Management Analyst (Medicaid)

 

About the opportunity:
We currently have openings for Advisory Services/Project Management Analysts with a strong interest in project management in our Medicaid project area. This role blends management, research, and technical assistance. As such, we are seeking prospective employees with a passion for project management and an interest in improving government operations and health care delivery. 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. Advisory services analysts work on a variety of projects spanning policy and programmatic areas and are likely to be connected to 2-3 projects at a time. These projects range from data analytics to program evaluation to implementation support. Candidates do not need to have experience in all of these areas but should have experience in at least one of them.

Across all projects, Advisory Services/Project Management Analysts are expected to:
• Provide the direction and organization needed to help keep Medicaid projects on time and on budget and facilitate communications across and between internal and external stakeholders.
• Conduct project management activities, such as helping project directors plan, manage, and close out complex projects and designing, implementing, and monitoring tools and processes to help organize data and manage teams.
• Perform complex analyses of projects to monitor and evaluate project performance and progress, including monitoring project costs, assessing earned value, and overseeing subcontractors.
• Develop and maintain project collaboration tools, including Microsoft Project schedules, SharePoint websites, Jira trackers, and Excel spreadsheets.
• Provide technical assistance to state and federal health agencies or healthcare providers by designing webinars or responding to questions from stakeholders.
• Draft client memos, technical documentation, proposals and other contractual deliverables, such as chapters for reports, case studies, and/or data dictionaries.

Position Requirements:
 

• Master’s degree in public policy, public administration, business, or related field; or commensurate experience in operations or management-oriented positions
• Strong management skills, including ability to monitor costs on multimillion-dollar contracts, mentor staff, and oversee small teams to complete work within tight timelines without compromising on quality.
• Strong organizational skills and high level of attention to detail; flexibility to manage multiple priorities, sometimes simultaneously, under deadlines.
• Excellent oral and written communication skills, for example the ability to write clear and concise technical documentation, and to communicate with clients diplomatically.
• Strong analytic and problem-solving skills, and ability to apply critical and creative thinking to identify solutions and respond to client requests in situations where guidance is unclear or absent.
• Professional experience in a similar field or position
• Interest in improving and researching Medicaid and other government programs, and/or providing technical assistance to health care entities.
• Some travel may be required
 

Desired Skills and Experience:
• Work experience with a state or federal agency, a foundation, or health care. program is highly desirable, as is prior experience working with Medicaid data.
• Knowledge of quantitative and/or qualitative research methods.
• Experience with management tools, such as Microsoft Project and Jira.
• Certifications demonstrating management proficiency and expertise, such as Project Management Professional (PMP) or Lean Six Sigma
• Experience engaging a range of client stakeholders by applying a variety of approaches (such as human-centered design).
• Experience bridging between business owners and technical staff
• Basic knowledge of software development lifecycles, and agile development.

Please submit a cover letter and your resume along with a work product that demonstrates analytic skills and reflects independent analysis and writing, such as a capstone project, analytic report, or a management plan (nothing company confidential, please).
Various federal agencies with whom we contract require that staff successfully undergo a background investigation or security clearance as a condition of working on the project. If you are assigned to such a project, you will be required to obtain the requisite security clearance.

This position is open in the following cities and states; however, we are all currently working from home and provide the support and flexibility needed to work from home. We ask the candidates to identify their preferred location for when we return to working in-person.

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

This position offers an anticipated annual base salary range of $60,000-$95,000. This position may be eligible for a discretionary bonus based on company and individual performance.

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.

 
 

Clipped from: https://www.careerbuilder.com/job/J3P0QK620SWZQVHH56F?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Job description

Overview:

Medicaid Project Coordinator in Albany, NY or NYC

Item 1223

Staffing Solutions Organization LLC (SSO), a wholly owned subsidiary of Public Consulting Group, is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.

Responsibilities: Summary: The Bureau of Maternal and Child Health Policy in the Division of Program Development and Management has overall responsibility for Medicaid policy and programs across various health services and initiatives, including but not limited to: perinatal standards of care and health benefits; community-based maternal services; early childhood screening and preventative services; school-based health services; and integrated physical and behavioral healthcare services for children.
The Medicaid Project Coordinator will provide planning, tracking and implementation support to various tasks and initiatives within the Bureau.
Responsibilities will include:

• Develop and maintain project management tools such as work plans, task trackers, and Gannt charts.
  
• Track tasks and deliverables for completion on schedule and identify and alert team to risks.
  
• Facilitate project team meetings to drive adherence to work plans and due dates.
  
• Provide meeting support, to include scheduling, agenda preparation, presentation and document development, documenting of action items.
  
• Lead communication workstreams for Medicaid pilot initiatives, to include maintaining the public webpages, authoring, and sending program announcements, overseeing general mailboxes and listservs, and serving as the point of contact for the public.
  

Qualifications:
Basic Qualifications:

• Bachelor’s degree
  
• At least 2 years of professional experience
  
• Must be a United States Citizen or a Permanent Resident of the United States in order to be considered
  

The successful candidate will meet the minimum qualifications for the position and demonstrate:

• Basic project management skills and general knowledge of effective project management methods.
  
• Ability to prioritize and organize across multiple assignments.
  
• Strong interpersonal and communication skills
  
• Proficiency with Microsoft Office Suite (Word, PowerPoint, Excel, Outlook)
  

 
 

• Employees must follow established work schedules. The usual work schedule is 40 hours per week, Monday through Friday. Normal work hours are 8:00 a.m. to 4:30 p.m. unless otherwise specified by the supervisor, this includes a half hour unpaid lunch break. Total work hours must equal 40 hours per week.
  

 
 

 
 

 
 

Clipped from: http://bigbendholidayhotel.com/work/

 
 

List of Jobs and Events

1. Operational Sleep Research Scientist
   

TechWerks Silver Spring

 
 

Senior Researcher – Medicaid

American Institutes For Research Columbia, MD Full-Time

OverviewAIR’s Payer Innovation, Transformation, and Support program area is seeking a Senior Researcher with a strong background in Medicare and Medicaid policy to join AIR’s Health Division. The Senior Researcher will support projects ranging from technical assistance and implementation support to evaluation and analytical support for CMS, states, and foundations.Candidates hired for the position might initially start working remotely but will eventually have the option to work from one of our offices located in Arlington, VA; Washington, DC; Rockville, MD; Columbia, MD; Austin, TX; Chicago, IL; Chapel Hill, NC or Waltham, MA or continue to work remotely.About AIR:Established in 1946, with headquarters in Arlington, Virginia, AIR is a nonpartisan, not-for-profit institution that conducts behavioral and social science research and delivers technical assistance to solve some of the most urgent challenges in the U.S. and around the world. We advance evidence in the areas of education, health, the workforce, human services, and international development to create a better, more equitable world.AIR’s commitment to diversity goes beyond legal compliance to its full integration in our strategy, operations, and work environment. At AIR, we define diversity broadly, considering everyone’s unique life and community experiences. We believe that embracing diverse perspectives, abilities/disabilities, racial/ethnic and cultural backgrounds, styles, ages, genders, gender identities and expressions, education backgrounds, and life stories drives innovation and employee engagement. Learn more about AIR’s Diversity, Equity, and Inclusion Strategy and hear from our staff by clicking here.ResponsibilitiesThe responsibilities for the position include:* Provide research and analytical leadership for major contract and grant research, implementation, technical assistance, and evaluation projects.* Conceptualize the vision for the required work, provide support for project teams in developing and carrying out the work, follow sound project management practices to ensure the timely completion of all deliverables within budget, and with high quality research standards that meet client requirements.* This position will require collaboration within and outside AIR, including with program providers, subject matter experts, as well as federal, state, and local agency officials.QualificationsEducation, Knowledge, and Experience:* Master’s degree in health administration, MPP, MBA or MPA (with health-related focus/concentrations) with 7+ years of experience in a similar contracted research/consulting firm, Federal or State-level government, or foundation that conducts policy and health services research, or PhD in public policy, economics, psychology, sociology, anthropology, other social science discipline with 3+ years of experience in a similar contracted research/consulting firm, Federal or State-level government, or foundation that conducts policy and health services research.* At least 4 years of experience working on Medicaid-related research.* Experience conducting research on Medicare, state-based health exchanges, or health and human service programs is preferred but not required.* Experience leading projects and/or tasks that require mixed methods:* Designing and leading evaluations and other types of mixed methods research, including:* Qualitative and quantitative data collection and analysis, including interviewing, conducting surveys, calculating or using descriptive and inferential statistics.* Using administrative data such as claims or other types of data used to administer large federal or state programs (Medicare, Medicaid, commercial health plan data, drug data, hospital data, TANF, SNAP, etc.)* Understanding and analyzing regulatory, sub-regulatory, and guidance materials.* Experience with, or exposure to, person-centered approaches and equity frameworks is desirable.* Ability to independently conceptualize, organize, draft, revise, and manage written deliverables such as reports, memos, PowerPoint presentations, or other client-facing materials.Skills:* Client management leadership skills:* Ability to interpret and as needed, clarify, client requests and manage client expectations; ability to manage project scope; ability to translate client asks into operational processes for execution (identifying staff, identifying steps, developing timelines); experience overseeing or guiding teams of more junior staff, including quality assurance.* AIR is seeking a Senior Researcher who values diversity, equity, and inclusion.* Comfortable working in a virtual/dispersed work environmentDisclosures:AIR requires all new hires to be fully vaccinated against COVID-19 or receive a legally required exemption from AIR, as a condition of employment. AIR will ask candidates to verify their vaccination status only after a conditional offer of employment is made. Applicants should not provide information about their vaccination status or need for exemption prior to receiving a conditional offer of employment from AIRApplicants must be currently authorized to work in the U.S. on a full-time basis. Employment-based visa sponsorship (including H-1B sponsorship) is not available for this position. Depending on project work, qualified candidates may need to meet certain residency requirements.All qualified applicants will receive consideration for employment without discrimination on the basis of age, race, color, religion, sex, gender, gender identity/expression, sexual orientation, national origin, protected veteran status, or disability.AIR adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks.#LI-DC1 #LI-Remote

Recommended Skills

• Market Research
  
• Research
  
• Marketing Research
  
• Global Marketing
  
• Analytics
  
• Life Sciences
  

Apply to this job.

Think you’re the perfect candidate?

Help us improve CareerBuilder by providing feedback about this job:

Job ID: 2260382508

CareerBuilder TIP

For your privacy and protection, when applying to a job online, never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction. Learn more.

By applying to a job using CareerBuilder you are agreeing to comply with and be subject to the CareerBuilder Terms and Conditions for use of our website. To use our website, you must agree with the Terms and Conditions and both meet and comply with their provisions.

 
 

Clipped from: https://www.careerbuilder.com/job/J3P46R60WLQ40RVHRFJ?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day Call Center Representatives Needed*.

Interested in supporting Medicaid providers?*.Conduent has immediate remote openings*.$15/HR & Great Benefits*.Summary:* Call Center Customer Service Representative.

This is a great opportunity to learn Medicaid provider support and the medical billing and claims process for third parties and healthcare providers regarding Medicare Claims What you get:* + Full-time employment with benefits + Hourly rate of.$15/hour* starting on day one. + Standard scheduled. 8am – 5pm Monday through Friday and then Saturdays 9am to 2pm.

+ Substantial Call Center & Customer Service Training + Great Work Environment with Career growth.People who succeed in this role have:* + Positive and energetic attitude. + Ability to communicate clearly and confidently.

+ Ability to multi-task and manage time effectively. + Attention to detail, grammar, and spelling accuracy. + Must type 25 wpm or more to qualify.

Responsibilities:* + Using a computerized system, responds to Kentucky Medicaid provider inquiries in a call center environment using standard scripts and procedures. + Gathers information, assesses caller needs, research and resolves inquiries and documents calls. + Provides clear and concise information regarding eligibility, claim status and provider enrollment status.

+ Follows documented policies and procedures including call handling and escalations. + Overall acts as an advocate for the Medicaid Provider to ensure their needs are met Additional Duties as Assigned:* + Verify documentation and images. + Attend scheduled staff meetings.

+ Complete required assigned training. + Track daily task for quality review Preferred Experience:* + One of year medical insurance or medical office experience. + Computer system experience with data entry and database documentation knowledge.

+ Call center or professional office experience Requirements* + Must be at least 18 years of age or older. + Must have a high school diploma or general education degree (GED). + Must be eligible to work in the United States.

+ Must be able to clear a criminal background check and drug test + Limited physical requirements: Typical office environment. Phone and keyboard for periods of time. Join a rapidly growing customer service organization that can support your career goals and Apply Today! This is a great opportunity to learn and be a part of the growing medical support community.

Conduent offers benefits and advancement opportunities. Come join us and help support our Medicaid providers! At Conduent, we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccinations for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible.

Providing this information is a requirement of your employment at Conduent. This does not disqualify you from this position. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the “Submit” button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form (https://downloads.conduent.com/content/usa/en/file/conduent-applicant-adaaa-referral-form.pdf) .

You may also click here to access Conduent’s ADAAA Accommodation Policy (http://downloads.conduent.com/content/usa/en/document/cdt\_adaaa\_accommodation\_pol.pdf) . The Colorado Equal Pay for Equal Work Act requires employers to disclose the following information.

If the successful applicant will be required to perform work from a physical site outside Colorado, the following information may not apply.Actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive.

In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation or sick time. _At Conduent,_ _we value the health and safety of our associates, their families and our community. Under our current protocols, we do not require vaccination against COVID for most of our US jobs, but may require you to provide your COVID vaccination status, where legally permissible._.

 
 

Clipped from: https://jobs.wfla.com/jobs/call-center-medicaid-support-work-from-home-for-the-state-of-kentucky-lexington-kentucky/682998497-2/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic