Medicaid Program Specialist I - Certification Reviewer

Title: Medicaid Program Specialist I (Certification Reviewer, PCN 062351)

Location: Anchorage, AK United States

Job Description:

Salary

$31.54 Hourly

Job Type

Full Time

As the Medicaid Program Specialist I, Certification Reviewer, you will play a key role in the certification process for current and prospective Medicaid Home and Community-Based Services (HCBS) providers. As a member of the Provider Certification and Compliance Unit, you will be primarily responsible for reviewing and evaluating applications in accordance with applicable standards for HCBS providers (waiver and personal care services) who apply to obtain or maintain certification to participate in Medicaid.

You will review and analyze provider documentation and issue determinations on certification applications, track and trend issues with providers, and make recommendations for quality improvement activities. In addition, you will serve in a vital technical assistance role for providers as well as process changes in provider statuses during certification periods. Collaboration with appropriate partner agencies and referrals for inappropriate service provisions and/or non-compliance are also included in the duties of this position.

Some Travel may be required in this postion.

Our organization, mission, and culture:

Senior and Disabilities Services promotes health, well-being, and safety for individuals with disabilities, seniors, and vulnerable adults by facilitating access to quality services and supports that foster independence, personal choice, and dignity.

The benefits of joining our team:

You will work with a talented, dedicated, and professional team that is driven to ensure quality services are provided to Alaska's most vulnerable citizens so they can thrive in their home communities. Working within a team of nine staff and in very close collaboration with other teams at SDS as well as other partner agencies, there is ample opportunity to have a positive impact on the lives of Alaskans as well as gain valuable professional experience in the field of Medicaid compliance, certification, and quality assurance.

The working environment you can expect:

This position is located in East Anchorage, next to East High School.

We are currently working in a hybrid teleworking model, with a 90-day in-person office requirement during initial hire and training.

This position is mostly office/home based, however, some local travel may be required.

Who we are looking for:

The ideal candidate will possess some or all of the following position-specific competencies in addition to the minimum qualifications listed below:

• Reading Comprehension: Understands and interprets written material, including technical material, rules, regulations, instructions, reports, charts, graphs, or tables; applies what is learned from written material to specific situations.
• Writing: Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a succinct and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.
• Interpersonal Skills: Shows understanding, friendliness, courtesy, tact, empathy, concern, and politeness to others; develops and maintains effective relationships with others; may include effectively dealing with individuals who are possibly difficult, hostile, or distressed; relates well to people from varied backgrounds and different situations; is sensitive to cultural diversity, race, gender, disabilities, and other individual differences.

Minimum Qualifications

Competency-Based Minimum Qualifications Instructions

This job class uses competency-based minimum qualifications. Please ensure your application (through work history, volunteer experience (duties summary), training, education, licenses, certifications, etc.) supports how you have gained the knowledge, skills, abilities, and behaviors (competencies) and that you possess the minimum required competencies for the job class.

Competency Description

The competency description(s) listed below have been designed to promote a common understanding of the essential elements of the job class. They highlight the more general and customary knowledge, skills, abilities (KSAs), tasks, and behaviors used to describe the competency. They typically list expectations rather than specific tasks and are to be used only as parameters and guidelines. A competency's description is not intended to exclusively define every KSA, task, and behavior needed to successfully meet the competency, but rather to provide the manager/agency with a broad reference of options as to how an applicant can meet the job expectation.

Please ensure your application (through work history, training, education, licenses, certifications, etc.) supports/demonstrates that you possess the minimum required competencies for the job class.

Any combination of education and/or experience that provides the applicant with competencies in:

Analytical Thinking/Problem Solving: Uses a logical, systematic, and sequential approach to address problems or opportunities or manage a situation by drawing on one's knowledge and experience base and calling on other references and resources, as necessary.

Oral Communication: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately.

Insurance Benefits

• Health insurance, which includes employer contributions toward medical/vision/dental
• Employer paid Basic Life insurance with additional coverage available (amount depends on Bargaining Unit)

Optional Insurance Benefits

• Group-based insurance premiums for
• Term life (employee, spouse or qualified same sex partner, and dependents)
• Long-term and short-term disability
• Accidental Death and Dismemberment
• Long-term care (self and eligible family members)
• Supplemental Survivor Benefits

Employee-funded flexible spending accounts for tax savings on eligible health care or dependent care expenses

Retirement Benefits

• Membership in the Public Employees Retirement System (PERS)/Teachers Retirement System (TRS)
• Matching employer contribution into a defined contribution program (new employees)
• Employer contribution into a defined benefit or defined contribution program (current employees)
• Contributions to the Alaska Supplemental Annuity Plan in lieu of contributions to Social Security
• Option to enroll in the Alaska Deferred Compensation Program
• Note: The Defined Contribution Plan, Supplemental Annuity Plan and Deferred Compensation Program offer a variety of investment options

Paid Leave & Other Benefits

• Personal leave with an accrual rate increase based on time served
• Twelve (12) paid holidays a year