Hybrid Medicaid Program Integrity Analyst

State of Alaska; Anchorage (AK); Híbrido; USD 70.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Hybrid work schedule

Descripción de la vacante

State of Alaska is seeking a Medicaid Program Specialist 3 in Anchorage. You will support CMS PERM processes, respond to errors, and engage with Medicaid providers to gather documentation.

This role emphasizes policy applications, detailed investigations, and ensuring program integrity. The position requires analyzing complex provider issues, using MMIS, Cognos, and data warehouses to identify billing and compliance concerns, and recommending corrective actions.

Formación

• Requires thorough attention to detail and ability to identify factual inferences.
• Experience in applying regulatory guidelines to audits and reviews.
• Ability to document findings clearly in oral and written form.

Responsabilidades

• Research CMS PERM-related errors and request information from Medicaid providers as needed.
• Investigate provider compliance issues and analyze claims using MMIS and Cognos tools.
• Perform focused provider reviews and develop corrective actions to improve performance.

Conocimientos

Attention to Detail

Investigation

Compliance

Analytical Thinking

Oral Communication

Written Communication

Technical Expertise

Herramientas

MMIS

Cognos

Data warehouse

Claims retrieval tools

Descripción del empleo

State of Alaska is seeking a Medicaid Program Specialist 3 in Anchorage. You will support CMS PERM processes, respond to errors, and engage with Medicaid providers to gather documentation.

This role emphasizes policy applications, detailed investigations, and ensuring program integrity. The position requires analyzing complex provider issues, using MMIS, Cognos, and data warehouses to identify billing and compliance concerns, and recommending corrective actions.