Medicaid Program Integrity Analyst (Hybrid)

State of Alaska; Anchorage (AK); Hybrid; USD 75,000 - 105,000; Full time

Benefits offered by this job

Hybrid work schedule

Free parking

Professional development opportunities

Job summary

State of Alaska seeks a Medicaid Program Specialist 3 to support Medicaid program oversight by reviewing provider compliance, claims, and utilization. The role is located in Anchorage within the Quality Assurance Section and emphasizes data analysis and actionable recommendations.

The position offers a hybrid work schedule, professional development opportunities through CMS/NAMPI/NHCAA, and a collaborative, security-conscious team environment.

Qualifications

• Attention to detail in evaluating provider data and documentation.
• Investigation knowledge: guidelines, regulations, and procedures.
• Compliance: assess, evaluate, and monitor programs for compliance with laws and guidance.

Responsibilities

• Support CMS PERM process by researching errors and contacting Medicaid providers to obtain information.
• Research moderate to complex provider compliance issues and claims per Medicaid policy.
• Conduct focused provider reviews using MMIS, Cognos, the MMIS data warehouse, and claims tools; analyze data and develop corrective action recommendations.

Skills

Attention to Detail

Investigation

Compliance

Analytical Thinking

Oral Communication

Technical Expertise

Written Communication

Tools

MMIS

Cognos

Data Warehouse

Claims Retrieval Tools

Job description

State of Alaska seeks a Medicaid Program Specialist 3 to support Medicaid program oversight by reviewing provider compliance, claims, and utilization. The role is located in Anchorage within the Quality Assurance Section and emphasizes data analysis and actionable recommendations.

The position offers a hybrid work schedule, professional development opportunities through CMS/NAMPI/NHCAA, and a collaborative, security-conscious team environment.