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Program Specialist - DHW - Medicaid

Posting Begin Date: 2024/07/02
Posting End Date: 2024/08/04
Category: Administration
Sub Category: Program Management
Work Type: Full Time
Remote: Flexible Hybrid
Location: Boise, ID, United States
Minimum Salary: 25.96
Maximum Salary: 27.00
Pay Rate Type: Hourly

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Description


DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS

***THIS ANNOUNCEMENT WILL BE OPEN UNTIL FILLED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE TO BE CONSIDERED.

The Division of Medicaid is currently seeking a Program Specialist - DHW with experience in Medicaid and/or other health care industry work, including government or commercial insurance health care backgrounds. The position is located in Boise’s Central Office. Candidates may request to telework, but telework is only available within the state of Idaho. No out-of-state telework requests will be approved. 

The Program Specialist - DHW position supports the Bureau of Financial Operations within the Division of Medicaid. This position collaborates with other Medicaid bureaus and programs, a variety of external stakeholders, legislative partners, and other state agency divisions/programs. As a Program Specialist - DHW, you will assist in the research, operations, and analysis of the provider reimbursement rate review and provider reimbursement rate review audits of home and community-based providers, institutional providers, long-term care providers, and long-term support services providers. The Program Specialist - DHW will assist in reporting to the governor’s office, the legislature, department leadership, and other external stakeholders that provider reimbursement rate adjustments are sound and appropriate in supporting Idaho’s provider network. 

Additional projects the Program Specialist - DHW may assist with include, but are not limited to, Medicaid state plan and/or waiver creation, renewals, amendment, and demonstration reports; third-party contracted cost surveys; conducting provider and external meetings with stakeholder groups; and reviewing and reporting on federal and state regulation changes to reimbursement and payment methodology. 

Candidates must be able to work independently, have strong organization skills, and be detail-oriented to manage multiple projects for multiple provider specialties. Candidates will have excellent written and verbal communication skills and the ability to work effectively in a multi-disciplinary team and environment.

BENEFITS:

BEST RETIREMENT AVAILABLE IN THE NATION 

We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit. 

OTHER EXCELLENT BENEFITS

  • 11 paid holidays
  • Generous vacation and sick leave accrual beginning as soon as you start 
  • Paid parental leave
  • Medical, dental, vision insurance - incredible rates!(full-time/30+ hours per week)
  • PERSI Choice 401(k)
  • Deferred compensation plan
  • Life insurance
  • Short and long-term disability insurance
  • Student Loan Forgiveness
  • Wellness programs
  • Employee Assistance Program (EAP)
  • Flexible Spending Accounts (FSA) 
  • Wide variety of training opportunities
  • Some positions offer flexible hours and/or telecommuting

 

EXAMPLE OF DUTIES:

The following are examples of duties assigned. The list is not exhaustive.

  • Assist in the coordination of the provider rate review implementation and analysis. May include data entry of submitted data and review of program specifications to compile information for final reports. 
  • Lead and monitor the long-term facility, home and community-based services, and long-term support services provider reimbursement rate data archive. May include analysis and presentation of certain data elements to state and federal oversight agencies. 
  • Assist in the development of reports related to reimbursement rate adjustments, fiscal/budget request recommendations for leadership, and other financial-based projections to ensure adequate reimbursement for provider networks. 
  • Develop materials, interpret analyses, and report out on federal and state reimbursement/payment methodology updates for internal and external stakeholders. 
  • Work with internal and external stakeholders to develop strategies for state and federal compliance monitoring for reimbursement-related activities. 
  • Assist in monitoring independent contractor work on independent review, audit, and/or survey work for home and community-based and long-term support services activities. 
  • Support state plan and waiver development and maintenance activities for provider reimbursement activities. 
  • Complete other duties, tasks, or assignments as assigned by management.

 

MINIMUM QUALIFICATIONS AND SPECIALTY MINIMUM QUALIFICATIONS:

You must possess all the minimum and specialty minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum and specialty qualifications for this position. Failure to do this may disqualify you from being considered for this position. It is highly recommended to attach a one-page cover letter to your application to demonstrate how you meet the requirements below.

MINIMUM QUALIFICATIONS:

  • Experience developing, recommending, and evaluating operating procedures and recommending changes. Typically gained by approximately one year of experience where this was a primary responsibility of the job. This experience may include participation in a regional or statewide quality assurance team, business change or project team or a similar assignment. 
  • Experience developing technical written materials such as policies, technical manuals or rules/regulations. Typically gained by at least one year experience working in a business setting developing training materials. reports, policy and/or procedure manuals, written interpretations of law, rules, or policies, or any related background which would be considered similar.
  • Experience providing technical program assistance to staff. Typically gained by at least one year of experience providing technical assistance to staff in a business setting which could include formal and informal assignments to assist, mentor or train new staff. 

SPECIALTY MINIMUM QUALIFICATIONS:

  • Experience researching, interpreting, and applying rules and laws. Typically gained through at least one year work experience using handbooks, policy and/or procedure manuals, written interpretations of law, rules, or policies.
  • Experience researching, interpreting and applying rules, policies, and procedures related to one or more of the following: Child Support, Food Stamps, Medicaid Eligibility, Cash Assistance to the Aged, Blind and Disabled (AABD). Typically gained through at least one year of experience working in a business setting using handbooks, policy and/or procedure manuals, written interpretations of law, rules, or policies related to one or more of these programs. 

Below is preferred experience. It is not required for the position but applicants with this experience may receive consideration over other applicants.

  • Good knowledge of social service programs serving the elderly and/or disabled, including social, economic, and health issues of the elderly and/or disabled; physical or biological sciences or related field. Typically gained by educational experience in a health care-related field or by at least one year of demonstrated work experience.
  • Experience working with Medicaid or healthcare/healthcare insurance programs and researching and analyzing data for accuracy, trends, variances, and updates to ensure acceptable policies and procedures have been followed and for compliance with Federal and State laws and regulations in general and those related to Medicaid reimbursement and certain enrollment requirements. Typically gained by at least one year of demonstrated work experience. 
  • Experience providing reports to leadership and management. Typically gained by one year of demonstrated work experience.
  • Experience working with financial accounting or auditing in healthcare providers and/or healthcare insurance programs. Typically gained by one year or more of demonstrated work experience.

Learn About a Career with DHW

 ***PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 4:59 pm on the closing date. When applying, use CHROME as your browser to avoid complications.

If you have questions, please contact us at:

Email is the quickest way to get an answer to your questions.

(answered Monday through Friday during business hours MST)

EMAIL: [email protected] 
PHONE:
(208) 334-0681

EEO/ADA/Veteran:

The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.

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