State Medicaid Data Warehouse Analytics SME

Are you a Medicaid Management Information System (MMIS) subject matter expert with technical/functional State Medicaid Data Warehouse Analytics experience? Do you want to help us transform the Medicaid market as it embraces modularization and we help our clients create a new future for Medicaid technology?

Work you’ll do

• Work on implementing MMIS or Medicaid Data Warehouse for State Medicaid Agencies
• Provide system level expertise across multiple computing platforms and technologies and work to influence direction around information management at the Enterprise Level
• Work with program managers, state directors and other key stakeholders, build sustainable relationships with key stakeholders responsible for information and performance management in client’s organization
• Organize knowledge transfer to clients
• Develop and manage vendor relationships
• Present in workshops for client education
• Manage team s on a data warehousing engagement

The team

Our Health Technology team implements repeatable solutions to solve our government clients’ most critical health technology related issues. We advise on, design, implement and deploy solutions focused on government health agencies “heart of the business” issues including claims management, electronic health records, health information exchanges, health analytics and health case management.

Our clients seek a fresh perspective on how to leverage reusable, interoperable and flexible solutions that will enable them to reduce costs, improve health outcomes and respond to public health crises. Professionals will use their deep health, government and technology consulting experience to strategically help solve our client’s technology challenges.

Qualifications

Required:

3+ years of experience within a Consulting or Health Technology environment

State MMIS experience

Data Warehouse experience

Bachelor’s Degree from an accredited College or University

Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future

Desired:

Experience within Medicaid Management Information systems (MMIS), Medicaid or Commercial Health Care claims, Provider Management and/or Eligibility data

Experience implementing a data warehouse for State Medicaid Agency

Experience with one of more of the following: SQL/PLSQL, ETL, Cognos, R, Python, Tableau, QlikView, Power BI, Business Objects

Experience in designing, analyzing, supporting and developing data warehouse objects, data quality processes, fact and dimension tables, logical and physical database design, data modeling, reporting process metadata and ETL processes.

Experience working in Cloud based environment (AWS or Azure)

Healthcare Data Analytics

Oral and written communication skills, including presentation skills (MS Visio, MS PowerPoint

 
 

Clipped from: https://jobsus.deloitte.com/columbia-sc/state-medicaid-data-warehouse-analytics-sme/485523490acf4fa5a8e8f4406e8c65b7/job/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Babylon Health is seeking a Social Worker to join the population health team in New York. We are looking for an experienced individual to help serve the communities that we have a presence in by assisting people that are affected by issues such as neglect, child abuse, domestic violence, mental health and parental substance abuse. 

 
 

This is a Managed Medicaid contract and  you will connect with your patients to assist in improving their health, better understand their illness, and coordinate their care.

 
 

Location:

This position is currently remote but, as public health guidelines evolve, may require occasional travel within your region.

 
 

Start Date:

August/September

 
 

Schedule:

You will be scheduled for shifts Monday to Friday from 8 AM – 5PM and 9 AM – 6PM (1 hour for lunch)

WHAT YOU’LL WORK ON

• You will be in charge of assessing clients and gathering relevant information about their cases, providing crisis intervention, and contacting and making referrals to other agencies and services.  
• As a member of a team of nurses, community health workers, registered dietitians, physicians, pharmacists, and program coordinators, you will have the opportunity to make a profound impact on the lives of people living with complex and/ or chronic conditions. 
• This Social Worker will connect with the patients remotely, over the phone, or in person at appropriate locations approved by the Company
• Documents clinical interventions and activities in patient’s clinical record and ensures appropriate hand off when transferring of patient care to ensure medical necessity and effectiveness
• Ensures patients are progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.

WHAT WE’RE LOOKING FOR

• Master’s degree in Social Work
• NY Licensed Social Worker (LMSW)
• While we’re more concerned with impact than years of experience, we’re targeting at least 5 years experience as a social worker and at least a few years working with Medicaid/Medicare/Vulnerable Populations
• Proficiency with navigating multiple software systems and different technologies

WHAT WE OFFER

• Annual base salary. The compensation range for this role will be shared during the early interview stages.
• 4 weeks’ paid vacation
• 401k’ with employer matching contribution
• Benefits include bonus, medical insurance, vision, and dental coverage
• Incredible growth opportunities with a global health tech startup with a meaningful mission

WHAT WE OFFER 

Whether you work in one of our amazing offices or a distributed team, Babylon is highly collaborative and fun! You’ll have a chance to work in a fast-paced environment with experienced industry leaders. We have a learning environment where you can make an impact.

 
 

WHO WE ARE

We are a team on a mission, to put accessible and affordable healthcare in the hands of every person on earth. Our mission is bold and ambitious, and it’s one that’s shared by our team who shares our values, to dream big, build fast and be brilliant. To achieve this, we’ve brought together one of the largest teams of scientists, clinicians, mathematicians and engineers to focus on combining the ever-growing computing power of machines, with the best medical expertise of humans, to create a comprehensive, immediate and personalized health service and make it universally available.

 
 

At Babylon our people aren’t just part of a team, they’re part of something bigger. We’re a vibrant community of creative thinkers and doers, forging the way for a new generation of healthcare. We’re only as good as our people. So, finding the best people is everything to us. We serve millions, but we choose our people one at a time…

 
 

DIVERSITY AT BABYLON

We believe that difference inspires a better, healthier world. That’s why it’s at the heart of everything we do. From our people to our products, difference enriches every part of our business and creates a culture based on equality of opportunity, and in which all Babylonians can progress their careers. We’re committed to creating an environment of mutual respect where equal employment opportunities are available to all applicants without regard to race, colour, religion, sex, pregnancy status, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information, and any other characteristic protected by applicable law.

Clipped from: https://jobs.lever.co/babylonhealth/3735b1e5-3b02-4c7c-b8f7-da69f9e223c6?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Location: Remote

Categories: Client Relationship Management / Service Delivery

Req ID: 2021-42228

Job Description

About Conduent

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.

Job Description

Seasoned pharmacy professional required to provide expert leadership and support for sales efforts. Supports sales processes as a Subject Matter Expert, with a deep understanding of current and near-future product and service offerings. Researches and analyzes competitor products and service offerings. Partners with technology and operational teams to improve & transform business (processes), optimize knowledge, skills, productivity, and quality. Contributes to and assists in any aspect of the sales, product or account management lifecycle.

***Position is “remote”–”work from home”and can be located anywhere, US***

Responsibilities Include:

• Manage and drive work across multiple functional teams on projects related to service delivery.
• Partners with technology and operations teams to define requirements and support offerings for PBM projects and business processes, including but not limited to, pharmacy claims, prior authorization, drug rebate, drug utilization review, and clinical services.
• Responsible for developing and maintaining a deep understanding of our solution set.
• Understands new software requirements and potential impacts to upstream and downstream users, stakeholders, and applications.
• Selects solutions appropriate to business opportunities and client needs.
• Understands and articulates the business value and impact of pharmacy offerings.
• Makes recommendations on future products and/or business offerings.
• Interprets business challenges and recommends best practices to improve products, processes or services.
• All other duties as assigned.

Experience and Education:

• 3+ years of Managed Care or PBM or pharmacy-related operations process improvement experience, with a preference for experience with Government Programs (Medicare, Exchange and/or Medicaid)
• Minimum 5 years of Medicaid Experience
• Minimum 5 years of Pharmacy Payer Experience
• Bachelor’s Degree Required

#techjobs

• Assists in researching technologies, best practices and market demand to put forth products to be sold to clients and prospects.

• Thought Leadership Development – collaborate on writing white papers, case studies and blogs.

• Sales Collateral Development – works with sales leadership and marketing to write client-facing collateral.

• Solution Development / Proposal Development – supports solution architects and delivery to address existing customer requirements.

• Represents the company at industry events.

• Developing industry knowledge expert.

 
 

Clipped from: https://jobs.conduent.com/job/13282260/pharmacy-benefits-solutions-professional-medicaid-implementation-specialist-remote/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Description


Connect for Health has a great opportunity for a Medicaid Contract and Program Manager!


Connect for Health Colorado is a public, non-profit entity established by the Colorado General Assembly in 2011 to create a health insurance Marketplace. Since 2013, we’ve been helping individuals, families and small employers compare plans, apply for financial help and buy health insurance. As Colorado’s official health insurance marketplace, we are the only place to apply for financial help to lower the monthly cost of premiums. Customers can shop online; get help by phone or online chat from Customer Service Center representatives; and access expert help from a statewide network of certified Brokers and community-based Assisters. For more information: ConnectforHealthCO.com


Position Summary


The Medicaid Contract and Program Manager is responsible for developing and implementing performance and success measures for Connect for Health’s Medical Assistance Site contract. They will analyze quantitative and qualitative data to help strengthen the customer experience, contract compliance, and operational efficiency.


Position Responsibilities

• Analyze quantitative and qualitative MA Site data to inform leadership actions and decisions with a focus on customer experience and contract compliance.
• Monitor, assess, and report on MA Site contract compliance, goals, and success metrics; identify any potential compliance risks and develop risk mitigation plans.
• Using data to analyze, develop, implement, and report on contract performance measures.
• Represent Connect for Health Colorado in meetings and workgroups regarding Medicaid/CHP+ policy and operational changes, identifying and speaking to the effect of changes on C4HCO.
• Coordinate and execute the tasks needed to ensure operational readiness and performance for Connect for Health Colorado’s contract to serve as a Medical Assistance Site for the State of Colorado.
• Responsible for the knowledge transfer of eligibility policy and procedures to C4HCO Training Manager and MA Site leadership to facilitate prompt updates to training materials and team processes and procedures.
• Work with internal teams across C4HCO, including policy, operations, training and product development to ensure that internal and external contract requirements and targets are met by creating project work plans to track activities, tasks, risks, issues, accomplishments, and schedules.
  
  

Requirements

• Bachelor’s degree or equivalent experience required.
• Four years or more of professional experience with contract and/or project management.
• Two or more years professional experience with Medicaid and CHP+ or other public assistance eligibility policy and procedures.
• Working knowledge of the Colorado Benefits Management System (CBMS), Colorado.gov/PEAK, and familiarity with associated data and reporting through dashboards and Cognos reports preferred.
• Experience using data to analyze, develop, implement, and report on performance measures.
• Prior experience managing contract performance.
• Prior experience working with diverse stakeholders.
• Experience researching and interpreting complex state and federal regulations and rules.
• Ability to set and prioritize workload, develop a work plan with tasks, time frames, milestones, resources, and dependencies.
• Strong communication skills, verbal and written.
• Experience leading process improvement events preferred.
• Colorado resident.
  
  

Work Environment

• Currently working remotely
• The Connect for Health Colorado office is in the North Tech Center area of Denver, near the intersection of I-25 and I-225
• Work schedule may include some non-traditional hours, weekends, and evening events.
• Core office hours, typically 8am-5pm with some flexibility
  
  

Total Compensation

Connect for Health Colorado offers a competitive benefits package. Using Connect for Health Colorado’s annual benefits allowance, employees may elect from various benefit offerings and tailor a package to best suit their individual needs. Connect for Health Colorado employees are eligible to participate in the organization’s 403(b) plan and are additionally provided with paid time off, short- and long-term disability and life insurance. The hiring range for this position is $71,100 – $87,900.

Clipped from: https://www.linkedin.com/jobs/view/medicaid-contract-and-program-manager-at-connect-for-health-colorado-2673228466/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Job Details

MEDICAID PROGRAM MANAGER 1–A

This listing closes on 8/16/2021 at 11:59 PM Central Time (US & Canada).

Salary $26.71 – $52.56 Hourly $4,630.00 – $9,110.00 Monthly

$4,630.00 – $9,110.00 Monthly

Location Baton Rouge, LA

Baton Rouge, LA

Job Type

Classified

Department

LDH-Medical Vendor Administration

Job Number

MVA/CSH/2293

Closing date and time

8/16/2021 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 / Eligibility Program Operations / East Baton Rouge Parish

Announcement Number: MVA/CSH/2293
Cost Center: 3052050401
Position Number(s): 50384011

 

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

 
 

No Civil Service exam required  

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 job experience on the application. Failure to complete an application may result in your application being disqualified.*

PLEASE NOTE:
Incomplete applications may result in your application being rejected. Include all education, work experience, licensure etc. that you would like to be taken into consideration for this job announcement. 
 
For further information about this vacancy contact:
Casey Hickman
Casey.Hickman@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:
Program Manager.

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

Supervision Exercised:
May provide functional supervision 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).

Differs from Medicaid Program Manager 1-B by the absence of supervisory responsibility.

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

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 small or less complex statewide program(s).

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 www.groupbenefits.org.

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

Holidays and Leave – State employees receive the following paid holidays each year: New Year’s Day, Martin Luther King, Jr. Day, Mardi Gras, Good Friday, Memorial Day, Independence Day, Labor Day, Veteran’s Day, Thanksgiving Day and Christmas Day. Additional holidays may be proclaimed by the Governor. State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.

Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works).  These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to): Louisiana State Employees Retirement System (www.lasersonline.org), Teacher’s Retirement System of Louisiana (www.trsl.org), Louisiana School Employees’ Retirement System (www.lsers.net), among others. LASERS has provided this video to give you more detailed information about their system.

Agency State of Louisiana Phone (866) 783-5462 Website http://agency.governmentjobs.com/louisiana/default.cfm

Address For agency contact information, please refer to
the supplemental information above.
Louisiana State Civil Service, Louisiana, 70802

Clipped from: https://www.governmentjobs.com/jobs/3175778-0/medicaid-program-manager-1-a?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 

About NYC Health + Hospitals

MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

Reporting to the Head of Product, the Director of Medicaid ensures operational excellence and regulatory compliance of all Medicaid products, owning the full spectrum of product strategy and operations. The Director will support key analytical activities to support the Plan’s strategic position, and will be proactive in identifying opportunities for performance improvement.

Job Description

• Provide oversight of Plan and vendor operations as they relate to the Medicaid line of business aligning outcomes to strategic goals & regulatory requirements.

• Develop & manage operational reports to track operational effectiveness.

• Partner with operational departments including Claims, Customer Service, Finance, Enrollment, Vendor Management, & Medical Management to design processes ensuring effective & efficient operations.

• Support key stakeholders in driving initiatives to meet quality & customer satisfaction goals.

• Maintain customer focus throughout Plan operations to ensure a seamless & excellent customer experience.

• Provide deep knowledge of & insight into the regulatory & market environment of Medicaid in New York to support the development of product strategy.

• Identify & integrate operational best practices, partnering with key departments to optimize processes across the organization such as benefits administration, risk adjustment, marketing & communications, customer experience.

• Monitor & analyze regulatory activity ensuring compliant operations & implementation.

• Perform competitive & market analysis.

• Partner with internal & external stakeholders on key strategic, regulatory, & operational projects.

Minimum Qualifications

• Bachelor’s degree from an accredited college or university in an appropriate discipline required.

• Master’s degree in business, healthcare or public administration strongly preferred.

• Minimum 5 years experience at a Health Plan with Medicaid Managed Care in a product management or compliance role.

• Thorough knowledge of Medicaid regulatory environment in NYS.

• Experience working with NYS enrollment transactions & encounter data submissions.

• Thorough understanding of interconnected managed care operations

• Demonstrated ability to develop workflows, policies, procedures.

• Demonstrated ability to identify opportunities for improvement & implement solutions.

• Excellent written & verbal communication skills.

• Excellent analytical skills demonstrated by an ability to use actionable data to support decisionmaking, and to proactively identify opportunities.

• Highly collaborative, and demonstrating good judgment in seeking consensus & input from multiple stakeholders to drive decision-making.

• Ability to take initiative & think independently

• Demonstrate understanding & acceptance of the MetroPlus Mission, Vision, & Values

Professional Competencies

• Leadership

• Results-driven

• Business acumen

• Systems orientation

• Process improvement

• Data-driven decision-making

• Customer focus

• Written/oral communication

• Resourcefulness

• Ability to work effectively in a fast-paced & constantly evolving environment

Clipped from: https://www.theladders.com/job/director-of-medicaid-nychealthandhospitals-org-new-york-ny_47072567?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

AHCCCS

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs, and a recipient of multiple awards for excellence in workplace effectiveness and flexibility. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry. AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona.

Grants Coordinator

AHCCCS

Posting Details:

Salary: $57,000-$60,000 
 

Grade: 21

Job Summary:

The Division of the Grants Administration (DGA) is looking for a highly motivated individual to join our team as a Grants Coordinator. This position will serve as a subject matter expert for integrated services for individuals determined to have a Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED), First Episode Psychosis (FEP), and on questions related to service delivery and oversight throughout Arizona. It is important that this position be able to determine appropriateness and effectiveness of state and federally funded mental health and integrated care services. The Division of Grants Management (DGA) is responsible for the application, oversight, monitoring, and implementation of contracts deriving from state and federal funding with an emphasis on the Mental Health Block Grant (MHBG). Under limited supervision, this position will evaluate the design, delivery, implementation, and effectiveness of the mental health services statewide. The position is grant funded and may be eliminated based on the availability of funding.

Job Duties:

* Oversee Mental Health Block Grant (MHBG) contracts and activities. Maintain close contact with Contractor’s staff regarding MHBG, Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED), and First Episode Psychosis (FEP) activities. Monitors contractor performance through the annual operational review, annual reports, site visits, and recurring coordination meetings. Provides training and technical assistance to contractors as needed.

* Serve as a Subject Matter Expert (SME) for integrated services for individuals determined to have a Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED), and First Episode Psychosis (FEP), for the Division of Grants Administration (DGA), which will include but is not limited to providing trainings to AHCCCS staff, contractors, and stakeholders as appropriate.

* Assist with and facilitate AHCCCS projects. Projects to include but are not limited to: submitting and assisting in the development of grant applications, navigating and managing data submissions to grant systems such as WebBGas and eRA Commons, federal deliverable development and submission, Contractor Expenditure Report (CER) reviews, and technical assistance provision.

* Prepare documents including protocols, policies and procedures, and contracts (as needed) for the development of requirements as they relate to the oversight of sub-grantees and contractors, outcome and progress reports written, communication, and presentations which include statistics and financial data pertaining to MHBG programs.

* Represents AHCCCS at national, state, and internal meetings and committees for the purpose of integrated behavioral health care.

* Works with community and state stakeholders and the federal government to develop, modify, adapt policies, and improve the efficacy of services in Arizona

* Project Management including grant work plans, timelines, and deliverables.

 

Knowledge, Skills & Abilities (KSAs):

* Experience providing mental health services, as well as knowledge of Arizona’s behavioral health program delivery system (mental health, substance use and integrated care).

* Knowledge of and/or experience in implementing evidence-based practices and research in Serious Mental Illness (SMI), Serious Emotional Disturbance (SED), and First Episode Psychosis (FEP) populations.

* Oversight and monitoring contractual requirements

* Computer skills including use of Microsoft Office (or comparable software program)

* Strong negotiation and problem resolution skills

* Effectively communicate orally and in writing

* Plan and implement complex initiatives, tasks and events

 

Selective Preference(s):

* Minimum Bachelor’s degree in the behavioral health field, or related field

* Two years of experience working in direct behavioral health services

* Master’s degree in behavioral health or related field preferred

* Multi-lingual preferred

 

Pre-Employment Requirements:

Valid Arizona Drivers License

Benefits:

At AHCCCS, we promote the importance of work/life balance by offering workplace flexibility and a variety of learning and career development opportunities. Among the many benefits of a career with the State of Arizona, there are 10 paid holidays per year, accrual of sick and annual leave, affordable medical benefits and participation in the Arizona State Retirement Plan.

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Contact Us:

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by contacting 602-417-4497.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.

 
 

Clipped from: https://jobs.azahcccs.gov/grants-coordinator/job/16817603?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

The Product Strategy Analyst is passionate and motivated by Healthfirst’s mission and wants to make a lasting impact in healthcare. This individual will create significant impact by providing the analytical support to the Medicaid Product Strategy team to develop, assist in execution, and continuously improve upon a strategy that supports a profitable growth across the Medicaid market portfolio of products.

• Work collaboratively with finance analysis, sales, marketing and other departments as necessary to support market growth plans to achieve market growth and profitability objectives 
• Compile information from multiple sources to prepare and distribute time-sensitive and accurate reporting for internal and external audiences 

 
 

• Support team in analysis of the financial performance of the Medicaid Products, identify favorable and unfavorable trends, develop recommendations to improve trends, communicate recommendations to management through a P&L focused mindset 
• Design, create, modify, support and maintain monthly competitive reports 
• Prepare ad-hoc reporting as required by senior management and external partners 
• Support team in creation of models to forecast growth performance and financial outcomes 
• Effectively manage projects by setting clear project milestones and deliverables; clearly communicating goals, objectives and responsibilities. Participate in meetings to gather and specify departmental requirements for such projects 

 
 

• Develop applications and reports using Microsoft Excel, Tableau and pertinent databases 

Minimum Qualifications: 

• Bachelor’s Degree from accredited institution 
• SAS, SQL and/or Tableau skills with ability to query, compile, and manipulate large datasets  
• Advanced skills in Microsoft Excel 

 
 

• A tendency to take full ownership of a situation or deliverable. This means having pride in one’s work, being an expert in the area, and a willingness to do whatever it takes to get to a result. 
• Understand and translate highly complex concepts to a wide range of audience. This means the ability to take a complex program or situation and break it down into simpler, constituent parts. 
• Experience in analyzing membership growth and retention trends and identifying drivers   
• Ability to efficiently validate data and analyses to identify potential errors in final results  
• Highly analytical person who can demonstrates problem solving and critical thinking skills. 

 
 

• Strong public speaking and oral and written communication skills with the ability to translate data to business insights (in other words, you are an analytic storyteller) 
• Team player who contributes to creating a positive work environment and willing to pull their sleeves up to get things done with a bias towards action and prototyping towards a solution. 
• Demonstrate intellectual curiosity and a desire to continue learning and growing. This means you want to go above and beyond to understand the business context. 

 
 

Preferred Qualifications: 

• Experience working in a health care delivery system or a health insurance company  
• Knowledge of Medicare and Medicaid programs, health care, and managed care  
• Python skills with ability to create automated data pulls and manipulations 
• Strong blend of IQ & EQ 

 
 

Clipped from: https://careers.healthfirst.org/us/en/job/R010350/Product-Strategy-Analyst-Medicaid?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

Overview
 

How have you impacted someone’s life today? At Hackensack Meridian Health our teams are focused on changing the lives of our patients by providing the highest level of care each and every day. From our hospitals, rehab centers and occupational health teams to our long-term care centers and at-home care capabilities, our complete spectrum of services will allow you to apply your skills in multiple settings while building your career, all within New Jersey’s premier healthcare system.

The Medicare & Medicaid Billing Supervisor responsible for the supervision and coordination of the day to day activities of the Government Patient Accounting Department Medicare, Medicaid, Charity, Secondary billing, and follow up. This position is also responsible for maintaining and upgrading the current financial system (HCS), the billing system (MedAssets), as well as numerous Government related websites. The Supervisor ensures that new employees are equipped with the necessary knowledge, equipment, tools, supplies, and applications in order to perform adequately in their new role. The Supervisor maintains and monitors time and attendance records to ensure accuracy and proper staffing. This position also ensures compliance with regulations and JFK Health System standard operating procedures. Supervising, coaching, training, and leading the Medicare, Medicaid, charity, and secondary billing team.

Responsibilities
 

 
 

• Reviews and ensures that daily electronic upload/download of billing and reporting activity has been run according to established procedures.
• Reviews and ensures that daily ‘State Charity’ required files are uploaded, corrected and sent to the appropriate state department for statistical/reconciliation reporting.
• Consistently works with the team to prevent accumulations of accounts that error by the electronic billing system.
• Responsible for overseeing that their team is kept up-to-date with the continuing changes in Government payor rules and regulations.
• Provides team with training and assistance. Makes sure everyone on there team is offered the same training to perform their daily functions.
• Works closely with both the billing system team leaders and the clearinghouses to ensure that claims are properly billed and reimbursed correctly.
• Performs job functions and follows all procedures when there is an absence in any one position.
• Responsible for maintaining all Government websites and their authorities for internal and external departments.
• Monitors staff interactions with all outside parties. Ensures that communications are appropriate and are done so while maintaining our service excellence culture.
• Orients new staff personnel regarding departmental policies and procedures.
• Provides annual written evaluation in a timely manner to address work performance, identifies learning needs, set mutual goals and address employee achievements.
• Maintains a fair, competent and objective demeanor, monitors on a daily basis their team’s performance.
• Identifies areas where improvement may be needed, documents and councils appropriately.
• When needed, institutes appropriate corrective action in a timely manner.
• Facilitates open communication within the department and with other departments.
• Demonstrates discretion in conversations with staff, patient and visitors in order to maintain confidentiality at all times.
• Responsible for attending all required meetings to establish a plan of action, training, and continual department enhancements.
• Responsible for establishing all requirements needed for specific departments to perform their daily functions.
• Responsible for testing all functions to ensure proper functionality from previous systems to new.
• Training of entire staff and outside departments on system use as well as continuing support for issues and additional ‘online’ help sessions.
• Works closely with assigned system representatives to ensure that claims are properly coded, demographics correct, as well as any insurance changes are implemented.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications
 

 
 

• High School Diploma or Equivalency required
• Minimum of 5 years experience in a hospital or business office setting performing Medicare/Medicaid billing required
• Advanced understanding of hospital billing required
• Advanced understanding of ICD-10, HCPCS/CPT coding and medical terminology required.
• Advanced understanding of compliance guidelines required
• PC Literate, Microsoft Office, Excel, Word, & Office, phone & fax required
• CPAT Certification preferred

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

Our Network

Hackensack Meridian Health (HMH) is a Mandatory COVID-19 and Influenza Vaccination Facility

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.

 
 

Clipped from: https://jobs.hackensackmeridianhealth.org/job/hackensack/medicare-and-medicaid-billing-supervisor/19511/11359882528?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic

 
 

 
 

 
 

Navitus Health Solutions / Lumicera Health Services, is currently hiring on a vacant job post of Business Analyst FFS Medicaid based in Appleton WI 54913. Please read the job detail carefully before applying.

Job Title: Business Analyst FFS Medicaid
Company Name: Navitus Health Solutions / Lumicera Health Services
Job Type: Full Time
Job Location: Appleton WI 54913
Salary:
Job Link Expiry: August 27, 2021

Job Detail

Job Summary:

The Business Analyst, Fee for Service (FFS) Medicaid “BA” will provide Business Analysis support for the development, implementation, and maintenance of various products within the FFS Medicaid Department. The initial product requiring support is the Prescriber Services Module. The scope of this module is to provide timely and accurate member and benefit information to prescribers. This module will also support workflows including submission of requests that support benefits and coverage, multiple interaction methods, and provider self-help tools. The BA will work with internal and external resources to assess business needs and translate those needs into process flows, detailed requirements, work breakdown structures, and other deliverables that support the development and implementation of a best in class tool.

The BA will apply proven communication, analytical, and problem-solving skills to help support development and product lifecycle activities.
Job Responsibilities:

Develop and maintain deep knowledge of FFS Medicaid needs, the competitive landscape, regulatory requirements, and related processes.
Collaborate with a wide range of internal and external business and technical resources.
Facilitate gap analysis and requirements gathering sessions for as-is and to-be of the products lifecycle.
Analyze use of products to understand behaviors and provide reporting as required.
With input from key stakeholders, prioritize needs of the product and communicate next steps for resolution.
Facilitate productive discussions to gather and document in both text and visual formats the expected functionality of the products.
Work with development teams to ensure functional and non-functional requirements are understood and implemented appropriately.
Perform testing and implementation activities to support these products.
Work with the team to identify, analyze, quantify, and mitigate risks.
Work with the project management office to utilize and enhance tools that support the requirements, development, and testing processes.
Manage issues/defects during the development process.
Collaborate with the training/development staff to deliver and update training documentation.
Create and update status reports that communicate the health of the products and related projects and enhancements.
Ensure our products and processes comply with relevant regulations.
Generate and suggest creative, considered ideas to support issue/problem diagnostics and brainstorming of potential solutions.
Perform other duties as assigned.
Essential Background Requirements:
Education:
Bachelor’s degree in Business Administration, Information Systems or related field and a minimum of 4 years of relevant experience.

Required Experience:
Documenting complex functional and non-functional requirements.
Participating in a development project team.
Experience with core software applications, including Microsoft Word and Excel.
Knowledge of Software Development Lifecycle (SDLC) methodologies.
Experience in roles like a Business Analyst, Business Systems Analyst, or Product Manager.

Preferred Experience:
Experience with customer facing web pages and/or portals.
Experience with Microsoft Visio, PowerPoint, Project and Team Foundation Server (TFS).
Healthcare industry practices and HIPAA knowledge.
Working experience with pharmacy benefits.
Experience in Mockups, Wireframing and Prototyping UI with UX principles.
Experience with multiple testing methodologies.
Experience with multiple (SDLC) methodologies and implementation of software solutions, systems, or products.
Business Analysis Certification (PMI, IIBA) or College level program.

Key Skills/Competencies:

Strong problem resolution and analytical skills.
Ability to be highly effective in a team-oriented environment.
Able to communicate effectively with members of interdisciplinary teams
Flexible and adaptable in regards to learning and understanding new technologies.
Keen attention to detail.
Ability to effectively prioritize and execute tasks in a high-pressure environment.
Ability to work both independently and in a team-oriented, collaborative environment.
On-call availability.
Some travel be required.

Clipped from: https://vacancypaper.com/jobs/business-analyst-ffs-medicaid-jobs-080821-1-7423/?utm_campaign=google_jobs_apply&utm_source=google_jobs_apply&utm_medium=organic