Medicaid Program Specialist 2 – Hybrid QA & Policy

State of Alaska; Anchorage (AK); Hybrid; USD 65,000 - 90,000; Full time

Job summary

The State of Alaska is seeking a Medicaid Program Specialist 2 to support the Care Management Program (CMP) and Surveillance and Utilization Review (SURS) in the Quality Assurance Unit. The role involves analytical, coordinative, and regulatory tasks within Medicaid/Medical Assistance programs.

Responsibilities include policy analysis, drafting procedures, monitoring claims, and conducting member reviews, with a hybrid in-office and remote work arrangement.

Qualifications

• Analytical thinking and problem solving are essential.
• Oral and written communication skills are required.
• Knowledge of Medicaid/Medicare programs is preferred.

Responsibilities

• Provide professional administrative support to the CMP and SURS teams.
• Coordinate, plan, implement and assess Medicaid activities; monitor no-shows; analyze policies and procedures.
• Draft policies, procedures, or regulations; oversee fiscal agent activities and claims processing reviews.
• Contribute to member reviews and prepare notification materials for program placement.

Skills

Analytical thinking

Oral communication

Written communication

Self-management

Problem solving

Writing

Job description

The State of Alaska is seeking a Medicaid Program Specialist 2 to support the Care Management Program (CMP) and Surveillance and Utilization Review (SURS) in the Quality Assurance Unit. The role involves analytical, coordinative, and regulatory tasks within Medicaid/Medical Assistance programs.

Responsibilities include policy analysis, drafting procedures, monitoring claims, and conducting member reviews, with a hybrid in-office and remote work arrangement.