Program Specialist DHW - MED

Description

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

Applications will be accepted through 4:59 PM MST on the posting end date. 

The Division of Medicaid, Bureau of Care Management (BCM) has an exciting opportunity to join a team monitoring performance and customer care of programs that interact with other IDHW programs, care providers, network service providers, and Medicaid members. This position is for a Healthcare Services Contract Monitor in Boise. 

BCM oversees most of the Division's managed care contracts such as duals, dental, vision and non-emergency medical transportation (NEMT) and service contracts such as External Quality Review and Independent Assessments for Development Disability. The bureau ensures managed care and service organizations provide quality contracted services to participants and providers and members have access to high quality care and support. These positions work directly with contractors and other contract monitors to evaluate performance and ensure compliance with contract provisions, state and federal regulations, and other requirements while also being responsible for program operations, member and provider support, and internal and external coordination for program evaluation, waiver management, and federal partnerships.

BCM is a supportive and dynamic team looking for applicants with a passion to support Idaho citizens by improving systems of care, and are excited to learn about federal and state healthcare systems. A successful candidate will have experience in healthcare or Public Health program planning and evaluation, be a solution oriented critical thinker, tactful negotiator, and a skilled communicator both verbal and written. Experience with developing contracts and agreements, healthcare policy research and analysis, troubleshooting participant issues, and daily application of program rules are extremely beneficial.

 If you are a self-starting, critical thinker with an interest in the many moving parts of a complex medicaid program, this may be a great fit for you! The position offers an opportunity to gain a depth of expertise in many aspects of Medicaid, while creating and maintaining relationships with key community partners and stakeholders.

Applicants must submit a cover letter outlining their knowledge, skills, and experience and why they are interested in the position.

This position may be eligible for telework after successful completion of probation and necessary training.

If you have previously applied for Program Specialist - DHW and wish to be considered for the current vacancy, you must reapply under this announcement. Previous scores will not be used.

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:

• Monitor daily and long term contractor performance in alignment with the provisions outlined in the contract's scope of work, Idaho Administrative Code (IDAPA), and applicable state and federal regulations.
• Support program development and quality improvement initiatives to ensure quality service delivery.
• Review program data for trends and proactively identify areas of concern. 
• Monitor issues reported to the program's team by internal and external stakeholders, dispatching for resolution and tracking trends for systemic issues. 
• Provide program support and education in assisting members navigating the program's benefits. 
• Support participant and stakeholder outreach activities, including presentations to varying group sizes about the program.
• Develop contract language to ensure high quality service delivery and monitoring activities. 
• Facilitate partnerships between healthcare providers and stakeholders and the contractor for successful service delivery.
• Support procurement of large and small contracts in coordination with DHW staff from multiple business units.

MINIMUM QUALIFICATIONS:

You must possess all the minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum 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.

• 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. 

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

• Experience monitoring or managing contracts.Typically gained by at least one year managing contracts including reviewing contractor data, auditing service delivery, monitoring financial data, and implementing corrective action for deficiencies.
• Experience explaining and applying state and federal laws, regulations, and complex policies for multiple or highly specialized programs.Typically gained by at least one year of related experience.
• Some knowledge of public health practices including survey methodology and statistical procedures used to collect, analyze and interpret data.Typically gained by at least one year of related experience.
• Experience in navigating eligibility systems for benefits or insurance plans to determine and communicate eligibility.Typically gained by at least one year of related experience.
• Experience in stakeholder engagement and public presentations with a variety of audiences.Typically gained by at least one year of related 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.

The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email [email protected].

Preference may be given to veterans who qualify under state and federal laws and regulations.