Program Analyst

When you become a member of Team DHCF (Department of Health Care Finance), the state Medicaid agency for the District of Columbia, you join our "Mission Possible!" We work every day, in concert with various District government agencies, to streamline access to comprehensive, affordable, and quality healthcare services for District residents. Whatever your position within our agency, you will positively impact beneficiaries, their families, and their future! We invite you to bring your skills, your experience and your passion to a job that makes a difference!

Job Summary

The incumbent serves as a Program Analyst responsible for providing oversight of Enrollee Services activities within the managed care program and overseeing performance and execution of the Enrollment Broker Services contract.

Duties And Responsibilities

Oversees and monitors all Enrollee Services activities performed by four (4) of the District of Columbia’s contracted Medicaid Managed Care Plans (MCPs), such as ensuring timely enrollment and disenrollment of Medicaid beneficiaries, access to timely services and their Rights and Responsibilities. Collaborates with the DC Access System (DCAS) to investigate and resolve eligibility issues related to Managed Care enrollees. Serves as the primary point of contact with the Office of Health Care Ombudsman and Bill of Rights to promptly resolve issues related to health plan assignments, enrollments and disenrollment's. Serves as the Contract Administrator of the Enrollment Broker Services contract, completing all delegated activities to ensure compliance with the scope of work that includes but not limited to timely and accurate mass enrollment of beneficiaries determined eligible for the DC Healthy Families Program (DCHFP), DC Healthcare Alliance (Alliance) and Immigrant Children’s Program (ICP).

Reviews complex, analytical written documents, and briefings on various healthcare administration topics associated with Managed Care and enrollee services. Serves as the primary point of contact with internal and external stakeholders such as healthcare providers, hospitals, ESA and other District agencies, and the Enrollment Broker to resolve issues related to outstanding enrollment, disenrollment and Medicaid ID assignments. Collaborates with the DC Office of Contracting and Procurement (OCP) to draft Requests for Proposals (RFPs) for solicitation of the Enrollment Broker contract.

Qualifications And Education

Specialized Experience – Experience that equipped the applicant with the particular knowledge, skills and abilities to perform successfully the duties of the position, and this is typically in or related to the work of the position to be filled. To be creditable, at least one (1) year of specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for the occupation in the organization.

Licenses and Certifications

None

Working Conditions/Environment

The work is performed in an adequately lighted, heated, and ventilated office environment

Other Significant Facts

Tour of Duty : Monday-Friday; 8:15AM - 4:45PM

Pay Plan, Series and Grade : CS-0343-14

Promotion Potential : No known promotion potential

Collective Bargaining Unit (Union) : This position is represented by a collective bargaining unit and is subject to union dues thru payroll deduction.

Residency Requirement : Applicants claiming “Residency Preference” will be required to maintain residency in the District of Columbia for a minimum of seven (7) years. Failure to do so may result in forfeiture of employment.

Position Designation: The position has been deemed security sensitive . Accordingly, the incumbent will be subject to pre-employment checks (criminal background checks, consumer credit check, traffic record checks, if applicable) as a condition of employment, and will be subject to periodic criminal background checks for the duration of your tenure.

If the position you are applying for is in the Career, Management Supervisory, or Educational Service at an annual salary of one hundred fifty thousand dollars ($150,000) or more, you must establish residency in the District of Columbia within one hundred eighty (180) days of the effective date of the appointment and continue to maintain residency within the District of Columbia throughout the duration of the appointment

EEO Statement: The District of Columbia Government is an Equal Opportunity Employer. All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.