Medical Program Specialist - MED

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 Idaho Department of Health and Welfare, Division of Medicaid has an exciting opportunity for a Medical Program Specialist in the Financial Recovery Unit to work independently and serve as the Medicaid third party liability and recovery contract monitor. Successful candidates must display reliability, excellent communication skills, attention to detail, a high level of professionalism, and the ability to successfully coordinate and complete multiple tasks. This position will be located in downtown Boise .

This position may be eligible for telework after successful completion of probation and necessary training. Approval to telecommute is not guaranteed and subject to termination at any time.

The Idaho Department of Health & Welfare is a drug-free workplace. Any applicant offered employment in this position at the Idaho Department of Health and Welfare will be required to pass a pre-employment drug test.

BENEFITS:

The State of Idaho offers a robust total compensation and benefits package, including but not limited to:

• We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit at retirement.
• 11 paid holidays
• Paid sick and vacation that begins accruing on your first day of employment; can be used immediately after accruing (no waiting time)
• Paid parental leave
• Medical, vision, and dental insurance benefits that become effective first of the month following your hire date. All contributions can be pre-tax (full-time/30+ hours per week)
• 2 voluntary supplemental retirement plans including both pre-tax and Roth options
• Deferred compensation plan
• Life insurance for self, spouse, and children
• Short and long-term disability insurance
• Flexible Spending Accounts (FSA)
• Wide variety of training opportunities
• Some positions offer flexible hours and/or telecommuting
• Additional perks and discounts available through medical provider
• Public Service Loan Forgiveness (PSLF) Eligibility
• Employee assistance program

Additional information related to benefits and/or State programs can be found here: https://dhr.idaho.gov/StateEmployees/Benefits.html.*

Example of Duties

• Performs contract monitoring for the third-party liability program for the Idaho Medicaid program
• Analyzes current, proposed, amended, and new program laws, regulations, and guidelines to assess program impact
• Collects and analyzes medical claims data for accuracy and quality control
• Identifies trends and recommends program changes
• Responds to inquiries from internal and external customers including other state departments, state officials, and the public
• Develops program forms and instructions
• Prepares program informational material for the media, legislators, other agencies, providers, clients, and the public
• Reviews reports and case samples to determine accuracy and adequacy of program policy implementation

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.

• Good knowledge of medical service delivery systems. Typically gained by completion of at least two college courses in a medical/health services field, public health or health care administration or related field (including but not limited to psychology, special education, RN, LPN, medical office assistant, etc.) AND one year of experience applying the knowledge in a medical service delivery system OR at least two years of experience as described.
• Some knowledge of current laws and regulations governing Title XIX Medicaid programs. Typically gained by one year of experience where knowledge and understanding of Title XIX Medicaid laws and regulations was a job responsibility.
• Some knowledge of training methods. Typically gained by successful completion of coursework or workshops of 16 hours or more covering communication concepts, learning styles, course design, and presentation skills or experience in presenting formal training sessions to groups.
• Experience developing instructional materials. Typically gained by one year of experience actually developing (not just presenting) instructional course content and materials.
• Experience evaluating program policies and procedures and recommending changes. Typically gained by one year of job experience which included the opportunity to evaluate the employer’s policies and procedures and provide input and/or recommend changes. Experience comparing employer’s policies and procedures to Medicaid or other governmental regulatory requirements would qualify as experience.

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

• Experience working with legal and financial documents, and solicitation of confidential information. Typically gained by six months of professional work experience where this was part of the job responsibility.
• Experience performing computerized records research in multiple proprietary and commercial systems. Typically gained by six months of professional work experience where this was part of the job responsibilities.
• Some knowledge of the tort claims; law, damages, and collection procedures used in the collection of subrogated debt. Typically gained by six months of professional work experience where this was part of the job responsibilities.
• Experience developing and evaluating policies, procedures, training and presentation materials; reviewing documents for accuracy, completeness, and compliance . Typically gained by six months of professional work experience where this was part of the job responsibilities.
• Good knowledge of basic insurance and general claims handling. Typically gained by six months of professional work experience where this was part of the job responsibilities.

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 11:59 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: dhwjobs@dhw.idaho.gov 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 ada.coordinator@dhr.idaho.gov.

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