Medicaid Program Lead (MMIS & Claims)

Alaska Horizon; Anchorage (AK); Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Free parking

Job summary

Alaska Department of Health is seeking a Medicaid Program Specialist 3 in Anchorage to support Medicaid claims processing and MMIS administration. Responsibilities include unit leadership, pricing and payment, service authorizations, NPI matching, and ensuring compliance with federal and state mandates.

The role requires monitoring regulatory changes and coordinating MMIS development with an emphasis on quality assurance and contract management.

Qualifications

• Knowledge of identifying, analyzing, and specifying requirements and translating them into technical requirements.
• Experience with quality assurance and configuration management of information systems.
• Understanding of Medicaid/health program administration and MMIS is a plus.

Responsibilities

• Oversee claims adjudication, pricing and payment, service authorizations, and NPI matching.
• Monitor federal and legislative mandates and regulatory changes affecting MMIS development.
• Lead and mentor team on quality assurance, contract management, and rules maintenance.

Skills

Analytical thinking

Oral communication

Written communication

Technical expertise

Job description

Alaska Department of Health is seeking a Medicaid Program Specialist 3 in Anchorage to support Medicaid claims processing and MMIS administration. Responsibilities include unit leadership, pricing and payment, service authorizations, NPI matching, and ensuring compliance with federal and state mandates.

The role requires monitoring regulatory changes and coordinating MMIS development with an emphasis on quality assurance and contract management.