Medical Program Specialist - MED

Idaho; Boise (ID); Hybrid; USD 40,000 - 80,000; Full time

Job summary

An established industry player in health services is seeking a dedicated Medical Program Specialist to enhance the quality of care for individuals with developmental disabilities. This role, based in Boise, will involve quality assurance activities, policy interpretation, and collaboration with various agencies to promote effective service delivery. The position offers the potential for a hybrid work arrangement after initial training, allowing for a balance of in-office and remote work. Join a team committed to making a positive impact on the lives of Idahoans and enjoy a comprehensive benefits package, including one of the best retirement systems in the nation.

Benefits

11 paid holidays

Generous vacation and sick leave

Paid parental leave

Medical, dental, vision insurance

PERSI Choice 401(k)

Deferred compensation plan

Life insurance

Short and long-term disability insurance

Student Loan Forgiveness

Wellness programs

Qualifications

• Knowledge of medical service systems and Title XIX Medicaid laws is essential.
• Experience in developing training materials and evaluating policies is required.

Responsibilities

• Conduct quality assurance activities for developmental disabilities services.
• Prepare reports and represent quality assurance perspectives in committees.

Skills

Knowledge of medical service delivery systems

Understanding of Title XIX Medicaid programs

Training methods

Instructional material development

Policy evaluation and recommendation

Education

College classes in medical/health service field

Bachelor's Degree in human services field

Job description

Description

DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS

Applications will be accepted through 4:59 PM MST on the posting end date.

The Division of Medicaid is currently filling for a Medical Program Specialist position to work in our Boise field office. This position will report to the Quality Assurance Program Manager and serve as a quality assurance/quality improvement specialist. The incumbent will work with the Bureau of Developmental Disability Services (BDDS) and other agencies to promote service delivery outcomes that focus on choice, empowerment, self-direction, and community involvement. The primary duties will also have responsibilities related to policies and procedures, as well as policy interpretation and technical assistance. There may be opportunity for a hybrid office/telework arrangement.

If you are interested in impacting the lives of people with developmental disabilities in a positive way, this is the job for you!

This position may be eligible for telework after successful completion of probation and necessary training.

The Idaho Department of Health & Welfare is a drug-free workplace. Any applicant offered employment in this position at the Idaho Department of Health and Welfare will be required to pass a pre-employment drug test. In addition, successful candidates will be required to complete a criminal history background investigation. Employment is dependent upon satisfactory results of the investigation.

BENEFITS:

BEST RETIREMENT AVAILABLE IN THE NATION

We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit.

OTHER EXCELLENT BENEFITS

• 11 paid holidays
• Generous vacation and sick leave accrual beginning as soon as you start
• Paid parental leave
• Medical, dental, vision insurance - incredible rates! (full-time/30+ hours per week)
• PERSI Choice 401(k)
• Deferred compensation plan
• Life insurance
• Short and long-term disability insurance
• Student Loan Forgiveness
• Wellness programs
• Employee Assistance Program (EAP)
• Flexible Spending Accounts (FSA)
• Wide variety of training opportunities
• Some positions offer flexible hours and/or telecommuting

EXAMPLE OF DUTIES:

• Quality assurance/improvement activities related to service delivery for individuals with developmental disabilities.
• Participate in on-site reviews of provider agencies and participant programs.
• Promote best practice models and consumer satisfaction outcomes.
• Prepare quality assurance survey reports.
• Conduct interviews and observations with participants, providers, and collateral contacts to ascertain if the provider agency is operating in accordance with state and federal rules and regulations.
• Assess the need for internal and external customer training.
• Develop training materials and conduct training as identified.
• Represent the Department's quality assurance/quality improvement perspective on committees, task forces, work groups, and projects.
• Respond to inquiries from other Department programs, the public, and the provider community concerning program laws, regulations, and guidelines.

MINIMUM QUALIFICATIONS:

You must possess all the minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum qualifications for this position. Failure to do this may disqualify you from being considered for this position. It is highly recommended to attach a one-page cover letter to your application to demonstrate how you meet the requirements below.

• Good knowledge of medical service delivery systems. Typically gained by completion of at least two college classes in a medical/health service field, public health, or health care administration or related field (including but not limited to psychology, special education, social work, certified nursing assistant course, RN, LPN, medical office assistant, etc.) AND one year of experience applying that knowledge in a medical service delivery system (including but not limited to medical institution, clinic, medical office, Medicaid service provider, etc.)
• Some knowledge of current laws and regulations governing Title XIX Medicaid programs. Typically gained through at least 1 year of experience where knowledge and understanding of Title XIX Medicaid laws and regulations was a job responsibility. Some job responsibilities include (but are not limited to): Direct service provision in a program that is reimbursed by Title XIX; quality assurance activities directed toward compliance with Title XIX regulations; billing for services to a State Medicaid program; answering questions/making referrals on Title XIX programs; and staffing activities directed towards compliance with Title XIX.
• Some knowledge of training methods. Typically gained by successful completion of coursework or workshops of 16 hours or more covering communication concepts, learning styles, course design, and presentation skills. It may also be demonstrated through experience presenting formal training sessions to groups.
• Experience developing instructional materials. Typically met through at least one year of experience actually developing (not just presenting) instructional course content and materials.
• Experience evaluating program policies and procedures and recommending changes. Typically gained through at least 1 year of job experience which included the opportunity to evaluate the employer's policies and procedures and provide input and/or recommend changes. Experience comparing the employer's policies and procedures to Medicaid or other governmental regulatory requirements would qualify as experience to meet this qualification.

Below is preferred experience. It is not required for the position but applicants with this experience may receive consideration over other applicants.

• Good knowledge of developmental disabilities. Typically gained by a Bachelor's Degree or higher in a human services field (including but not limited to psychology, nursing, physical therapy, speech therapy); OR at least two years of experience working with individuals with developmental disabilities.
• Some knowledge of investigative methods and standards. Typically gained by training or coursework in investigative methodology, conflict management, and de-escalation techniques; OR at least one year of experience conducting fact-finding investigations.
• Experience planning, organizing, monitoring, and evaluating a healthcare-related program; analyzing cost-effectiveness of methods of health care delivery. Typically gained by at least one year of professional experience performing related work such as a Facility Administrator, RN, Qualified Mental Retardation Professional, or Developmental Specialist; OR at least one year of experience as part of a Quality Assurance, Quality Improvement, administrative-directed program (please be specific when describing your experience).

Learn About a Career with DHW

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EEO/ADA/Veteran:

The State of Idaho is committed to providing equal employment opportunities and prohibits discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibits discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.

The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities; auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact [phone] (TTY/TTD: 711), or email [e-mail].

Preference may be given to veterans who qualify under state and federal laws and regulations.