Medicaid Program Associate (PCN 061050)

State of Alaska; Anchorage (AK); Hybrid; USD 55,000 - 75,000; Full time

Benefits offered by this job

Hybrid work schedule

Training opportunities (MII/NAMPI/NHCA

Free parking

Job summary

The State of Alaska invites qualified applicants to join the Medicaid Program Integrity team as an Audit/Review Associate in Anchorage. You will research provider and claims information, organize documentation, maintain case records, and track activities to support fraud, waste, and abuse prevention in Medicaid.

This exempt position emphasizes attention to detail, organized information management, and effective communication with providers and Department staff.

Qualifications

• Customer Service: Anticipates and meets the needs of both internal and external customers.
• Oral Communication: Communicates ideas clearly to diverse audiences.
• Written Communication: Writes clearly and persuasively for the intended audience.
• Equivalent To Those Typically Gained By Experience including business admin, computer science, economics, healthcare, or public health.
• Special Note: Competencies are a combination of knowledge, skills, abilities and behaviors.

Responsibilities

• Support audit and review staff by researching provider and claims information.
• Review and organize supporting documentation and maintain accurate case records.
• Track audit and review activities and follow up on identified concerns with timely communication.

Skills

Attention to Detail

Organized Information

Technical Credibility

Job description

Job Description

This Individual Position is Exempt from the Hiring Freeze. Qualified Applicants are Encouraged To Apply.

Welcome to the Department of Health!

We’d be delighted to have you join our team.

This position is open to Alaskan Residents only.

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

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.

Who We Are Looking For

• 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.

Minimum Qualifications

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.

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 course work 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, online, 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.

Additional Required Information

At the time of the interview, please provide the following:

• 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.
• Current performance evaluation, if available.
• 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

Kristina Harp / Audit Review Analyst 4

Phone: [phone]

Email: [e-mail]

EEO / DEI / Diversity / Inclusion 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.

Visa Sponsorship

The State of Alaska does not provide VISA Employer sponsorships.

Careers With The State Of Alaska Offer MANY Benefits

The following information describes typical benefits available to employees of the State of Alaska. Actual benefits received may differ by bargaining unit or branch of government, position type, or be prorated for other than full time work.

Insurance Benefits

• Health insurance, which includes employer contributions toward medical/vision/dental
  • The following employee groups are under AlaskaCare Benefits administered by the State: See https://drb.alaska.gov/help/plans.html for additional information.
  • AVTEC
  • Confidential
  • Correctional Officers
  • Marine Engineers
  • Mt. Edgecumbe Teachers
  • Supervisory
  • Unlicensed Vessel Personnel/Inland Boatman’s Union
  • Exempt employees (not covered by collective bargaining)
  • The following employee groups are covered by Union health trusts. Contact the appropriate Union for additional information.
    • General Government
    • Labor, Trades and Crafts
    • Public Safety Employees Association
    • Masters, Mates & Pilots
  • 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