Eligibility Policy Analyst

Empower AI; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking an Eligibility Policy Analyst to ensure compliance with Medicaid and CHIP eligibility policies. This remote role offers the chance to work independently while collaborating with a dedicated team. You will conduct thorough policy research, provide technical assistance, and uphold high standards of customer service. If you have a passion for detail and a strong understanding of eligibility principles, this position is an excellent opportunity to contribute to the efficiency of essential programs.

Qualifications

• 3+ years of experience conducting Medicaid/CHIP eligibility reviews.
• Ability to analyze Medicaid and CHIP regulations and their impacts.

Responsibilities

• Ensure accuracy and compliance of Medicaid and CHIP eligibility policies.
• Provide technical assistance to state staff and eligibility reviewers.

Skills

Medicaid eligibility interpretation

CHIP eligibility analysis

Quality assurance activities

Organizational skills

Customer service

Written and verbal communication

Education

Bachelor's degree

Job description

Eligibility Policy Analyst

Job ID

2024-7851

Job Locations

US-Remote

Category

Analyst (Business, Systems, Data)

Type

Regular Full-Time

Responsibilities

We are currently seeking dedicated and detail-oriented individuals to join our team as an Eligibility Policy Analyst. As an Eligibility Policy Analyst on the PERM program, you will play a crucial role in ensuring the accuracy and compliance of Medicaid and CHIP eligibility policies. This remote position offers the flexibility to work independently while contributing to the success of our program.

Responsibilities:

Collaborate closely with the Project Director and Eligibility Manager to align policy efforts with project goals.
• Provide essential technical assistance to state staff and eligibility reviewers, ensuring consistent policy application.
• Utilize your program knowledge to identify and address eligibility policy issues, promoting efficient and accurate processes.
• Assist in identifying additional Eligibility Policy Analysts who possess the necessary criteria and experience.
• Demonstrate an in-depth understanding of Medicaid and CHIP eligibility principles and practices.
• Work independently to conduct thorough policy research, analysis, and recommendations.
• Uphold a high standard of customer service by addressing inquiries promptly and effectively.
• Ensure adherence to departmental policies, procedures, and guidelines.
• Comply with the Statement of Work (SOW) guidelines and CMS directives and regulations.
• Collaborate effectively within the PERM team, communicating at all levels.
• Attend departmental meetings and required education and training programs.

Qualifications

Qualifications:

• Ability to interpret Medicaid, CHIP, and state eligibility regulations and to analyze their impact on current and proposed programs;
• A minimum of three (3) years of experience conducting Medicaid/CHIP eligibility reviews;
• A minimum of five (5) related experience;
• Bachelor's degree or equivant;
• Experience conducting quality assurance activities related to Medicaid and CHIP eligibility case reviews; and
• Experience conducting eligibility reviews for the PERM or similar program.
• Considerable program knowledge of Medicaid and CHIP eligibility principles and practices.
• Strong organizational skills and meticulous attention to detail.
• Excellent customer service skills, with the ability to communicate policies clearly.
• Proficient in performing routine activities while adhering to deadlines.
• Self-motivated and capable of working effectively in a remote setting.
• Demonstrated ability to collaborate within a team-oriented environment.
• Exceptional written and verbal communication skills.
• Familiarity with CMS directives and regulations related to eligibility policies (preferred).

This remote position offers an excellent opportunity to contribute to the accuracy and efficiency of our Medicaid program's eligibility policies. If you are an independent thinker, possess a passion for detail, and thrive in a collaborative environment, we encourage you to apply.

About Empower AI

All hiring and promotion decisions at Empower AI are based on merit to bring the best talent available to contribute to our firm's overall success. It is the policy of Empower AI not to discriminate against any applicant for employment, or employee because of age, color, sex, disability, national origin, race, religion, or veteran status. Empower AI is a VEVRAA Federal Contractor.

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