Medicaid Program Associate

State of Alaska; Anchorage (AK); Hybrid; USD 65,000 - 80,000; Full time

Benefits offered by this job

Free parking

Hybrid work schedule

Professional development opportunities

Job summary

State of Alaska seeks a Medicaid Program Associate to support the Medicaid Program Integrity team. You will research provider and claims information, organize documentation, and maintain case records while coordinating with providers and Department staff to address identified concerns.

This role emphasizes attention to detail, effective communication, and collaboration in a hybrid Anchorage office environment.

Qualifications

• Attention to detail in handling data, documentation, and case records.
• Ability to gather, organize, and maintain information accurately for audits.
• Understanding and applying regulations, policies, and procedures relevant to Medicaid integrity.
• Deliver high-quality service to internal and external customers with a focus on accuracy.
• Clear written and oral communication tailored to various audiences.

Responsibilities

• Assist audit and review staff by researching provider and claims information.
• Review and organize supporting documentation and maintain accurate case records.
• Communicate with providers, contractors, and Department staff to obtain information and support timely follow-up.
• Help ensure issues are documented, followed up on, and resolved to prevent fraud, waste, and abuse.

Skills

Attention to Detail

organizes information

Technical Credibility

Customer Service

Oral Communication

Written Communication

Job description

This position is open to Alaskan Residents only.

Please check out the residency definition to determine if you qualify.

What you will be doing:

As the Medicaid Program Associate, you will play an important role in supporting the Medicaid Program Integrity and protecting Medicaid resources. You will assist audit and review staff by researching provider and claims information, reviewing and organizing supporting documentation, maintaining accurate case records, and tracking audit and review activities. You will communicate with providers, contractors, and Department staff to obtain information and support timely follow-up on identified concerns. Your attention to detail and ability to organize and manage information will help the Medicaid Program Integrity team ensure identified issues are properly documented, followed up on, and resolved while supporting the Department’s efforts to prevent and address fraud, waste, and abuse within the Medicaid program.

Our organization, mission, and culture:

The Department of Health, Medicaid Program Integrity is a small team whose mission is to preserve and protect the integrity of the Medicaid program by proactively developing strategies to identify, deter, and prevent fraud, waste and abuse.

The benefits of joining our team:

This position offers an opportunity to work with a team of professionals dedicated to safeguarding the integrity of the Medicaid program by proactively developing strategies to prevent fraud, waste, and abuse. Our team encourages continual learning, including training opportunities through the Medicaid Integrity Institute (MII) hosted by Centers for Medicare and Medicaid Services (CMS), the National Association for Medicaid Program Integrity (NAMPI), and the National Health Care Anti-Fraud Association (NHCAA). Team members currently enjoy a hybrid work schedule that includes time in the office and time teleworking, and it encourages a collaborative and supportive work environment.

The working environment you can expect:

This position is in the Frontier Building in midtown Anchorage, a secure office space with free parking. We offer a professional office environment with daily collaboration among dedicated colleagues and offer a hybrid work schedule.

Competency-Based Minimum Qualifications:

• Attention to Detail: Is thorough when performing work and conscientious about attending to detail.
• Manages and Organized Information: Identifies a need; gathers, organizes, and maintains information; determines its importance and accuracy, and communicates it by a variety of methods.
• Technical Credibility: Understands and appropriately applies principles, procedures, requirements, regulations, and policies related to specialized expertise.
• Customer Service: Anticipates and meets the needs of both internal and external customers. Delivers high-quality products and services; is committed to continuous improvement.
• 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.
• Written Communication: Writes in a clear, concise, organized, and convincing manner for the intended audience.

Any combination of education and/or experience that provides the applicant with competencies in customer service, oral communication, and written communication, as well as the knowledge, skills, and abilities specific to the required competencies, is considered equivalent to those typically gained by experience applying program requirements and working with individuals in stressful situations and/or training or education which includes such coursework as business administration, computer sciences, economics, healthcare, legal studies, medical billing or coding, public health, public assistance, psychology.

Special Note:

“Competencies” means a combination of interrelated knowledge, skills, abilities, and behaviors that enable a person to act effectively in a job or situation.

“Training” and “education” in this guidance are synonyms for the process of acquiring knowledge and skills through instruction. It includes instruction through formal and informal methods (such as classroom, on-line, self-study, and on-the-job), from accredited and unaccredited sources, and long-duration (such as a post-secondary degree) and short-duration (such as a seminar) programs.

“Typically gained by” means the prevalent, usual method of gaining the competencies expected for entry into the job.

Required Documents and References:

1. Three (3) professional references, whom we may contact by phone, are required. One (1) of these references must be your current or most recent supervisor, if not already provided in the application.
2. Current performance evaluation, if available.
3. A copy of academic transcripts (unofficial is okay; please ensure that the institution name/URL is listed on the transcripts) is used to support that you meet the minimum qualifications competencies.

Contact Information

For specific information in reference to the position, feel free to contact the hiring manager at:

Name: Kristina Harp / Audit Review Analyst 4

Phone: [phone]

Email: [e-mail]

EEO STATEMENT

The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA). Individuals with disabilities who require accommodations, auxiliary aids, or services, or alternative communication formats, please call 1-800-587-4095 in Juneau or TTY: Alaska Relay 711 or 1-800-770-8973 or correspond with the Division of Personnel & Labor Relations at P.O. Box 110201, Juneau, AK 99811-0201. The State of Alaska is an equal-opportunity employer.