Senior Healthcare Program Coordinator (HCA/MAD #7579)

New Mexico Department of Justice; Santa Fe (NM); On-site; USD 65,000 - 90,000; Full time

Job summary

The New Mexico Health Care Authority is seeking a Senior Healthcare Program Coordinator to research and clarify Medicaid policies for existing and new programs, and to identify complex issues affecting a recipient's benefits.

You will oversee the Dental, Transportation and Vision programs, coordinate with multiple bureaus and assist providers with FFS claims and MCO inquiries, ensuring policy alignment and service delivery.

Qualifications

• Associate degree in Business Administration, Healthcare Administration, Statistics, Finance, or a related field.
• Two years of experience with a public assistance program, medical/healthcare, or state policy.
• Four years total education/experience may substitute for the required education and experience.
• Must possess and maintain a valid Driver's License; Defensive Driving Certification.

Responsibilities

• Serve as the Program Coordinator in the Program and Policy Bureau.
• Oversee the Dental, Transportation and Vision programs, reviewing concerns related to these programs.
• Assist providers with Fee-for-Service (FFS) claims and Managed Care Organization (MCO) inquiries.

Education

Associate degree in Business Administration

Associate degree in Healthcare Administration

Associate degree in Statistics

Associate degree in Finance

Related field

Job description

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For more Job Requirements & Classification Description:

Interviews are anticipated to be conducted within two weeks of closing date.

This job posting may be used to fill multiple vacancies.

The Health Care Authority (HCA) participates in E-Verify and will verify employment eligibility upon hire.

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees continuous growth and wellness.

Why does the job exist?

The Senior Healthcare Program Coordinator will:

• Conduct research to identify and evaluate complex issues that impact a Medicaid recipient's benefits and services;
• Clarify, develop, and implement Medicaid policies for current and new programs;
• Address and resolve complex Medicaid issues that may require collaborating with other Medicaid bureaus, divisions and/or agencies.

How does it get done?

The Senior Healthcare Program Coordinator is responsible for:

• Serving as the Program Coordinator in the Program and Policy Bureau;
• Overseeing the Dental, Transportation and Vision programs, reviewing all concerns related to the programs;
• Assisting providers with both Fee-for-Service (FFS) claims and Managed Care Organization (MCO) inquires.

Who are the customers?

• Managed Care Organizations (MCO);
• Other Federal and State Agencies;
• Providers and managers.

Ideal Candidate

The Ideal Candidate has:

• Knowledge of the Medicaid program, or other state or federal healthcare programs;
• Experience writing, reviewing and implementing process and policy;
• Experience conducting research and analyzing complex information.

Associate degree in Business Administration, Healthcare Administration, Statistics, Finance, or a related field and two (2) years of experience with a public assistance program, medical, healthcare, educational, or state facility working with policies and procedures, conducting analysis/research, providing or requesting information from the general public, working with communities, working on health or social service related matters, social work/case management, behavioral health, and/or health care. Any combination of education from an accredited college or university in a related field and/or direct experience in this occupation totaling four (4) years may substitute for the required education and experience.

Employment Requirements

Must possess and maintain a valid Driver's License.
Must obtain a Defensive Driving Certification.

Working Conditions

Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT), extensive personal computer and phone usage. Must be able to lift 25lbs.

Supplemental Information

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For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.

Bargaining Unit Position

This position is covered by a collective bargaining agreement and all terms/conditions of that agreement apply and must be adhered to.