Medicaid Program Specialist 2 – (SURS Administrative Coordinator

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

Medicaid Program Specialist 2 - (SURS Administrative Coordinator (PCN 064062))

In this role, the SURS Administrative Coordinator provides a variety of professional-level administrative functions to support the Care Management Program (CMP) and Surveillance and Utilization Review (SURS) teams in the Quality Assurance Unit. You will be responsible for a variety of assignments that are analytical, coordinative, implementing, and assessing, and require knowledge and experience with Medicaid/Medical Assistance programs and services.

Additionally, the position provides a variety of professional services and assignments such as coordinating, planning, implementing, and assessing Medicaid activities; monitoring no-shows; providing policy and procedure analysis, interpretation, or input; drafting policy and procedure or regulations; overseeing numerous fiscal agent activities; reviewing authorization and claims processing activities; and providing other professional services to administer and maintain Medicaid/Medical Assistance programs, including conducting member reviews and generating notification materials for program placement in line with the Department policies and State and Federal regulations.

This position may respond to and provide research for a variety of tasks such as Fair hearing research, analyzing claim data, ensuring compliance with program requirements, and assisting with CMP and SURS processes.

Our organization, mission, and culture: The Quality Assurance unit is instrumental in ensuring that the integrity of the Medicaid Program is protected. The mission of the Division is to provide all eligible Alaskans with access to quality Medicaid services. The vision of the Division is to improve quality of health care for all Alaskans, attract excellent providers, and provide outstanding customer service. The contributions of the selected candidate ensure that the goals and vision of the Division are met by ensuring programs conform to federal and state rules and regulations.

The benefits of joining our team: The Quality Assurance Unit (QA) is a multi-faceted environment where we strive to create a balance between hard work, compassion, collaboration, and fun. We are a dynamic, diverse, high-performing team of highly dedicated, hardworking individuals committed to ensuring our vulnerable population’s health, well‑being, and safety. All team members’ input is valued, and we are always looking to provide growth and learning opportunities for our team members. The QA team operates on a hybrid work schedule with a mix of in‑office and work from home days.

The working environment you can expect: Our office is located midtown in the Calais Building, at 3201 C. Street. Ste. 202. The workspace is clean, bright, and features mountain views from the office suite. This position also features an assigned parking space for convenience.

Who we are looking for: We are interested in candidates who possess some or all of the following position-specific competencies:

• Self-Management: Sets well-defined and realistic personal goals; displays a high level of initiative, effort, and commitment towards completing assignments promptly; works with minimal supervision; is motivated to achieve; demonstrates responsible behavior.
• Writing: Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a brief, clear, and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.
• Problem Solving: Identifies problems; determines accuracy and relevance of information; uses sound judgment to generate and evaluate alternatives, and to make recommendations.

Special Notice:

• Basic knowledge of Medicaid/Medical Assistance terminology, programs, policies and procedures, and rules and regulations at the state and federal levels is preferred.
• Sufficient knowledge of Medicaid and/or other health care services, health care claiming and delivery systems is preferred.

Minimum Qualifications: The competency description(s) listed below have been designed to promote a common understanding of the essential elements of the job class. They highlight the more general and customary knowledge, skills, abilities (KSAs), tasks, and behaviors used to describe the competency. They typically list expectations rather than specific tasks and are to be used only as parameters and guidelines. A competency’s description is not intended to exclusively define every KSA, task and behavior needed to successfully meet the competency, but rather to provide the manager/agency with a broad reference of options as to how an applicant can meet the job expectation.

Any combination of education and/or experience that provides the applicant with competencies in: Analytical Thinking/Problem Solving, Oral Communication, Written Communication.

Equivalent to those typically gained by: Progressively responsible experience such as supporting the administration of a Medicaid or Medicare program, health insurance service, health insurance management information system, health insurance finance or accounting program, Supplemental Security Income benefits or vocational rehabilitation program; auditing or monitoring medical or public assistance programs for fraud or quality assurance; processing medical claims using medical coding and medical billing knowledge; designing, developing, testing for quality assurance, and implementing an information system 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.

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

“Progressively responsible” means indicating growth and/or advancement in complexity, difficulty, or level of responsibility.

“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.

Contact Information

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

Name/Title: Elizabeth LaRue/SURS Manager
Phone: [phone]
Email: [e-mail]

Phone [phone] (Statewide toll‑free number)
[phone] (Juneau and out‑of‑state callers)