Senior Managed Care Oversight Analyst (Hybrid/Remote)

State of Michigan; Lansing (MI); Hybride; USD 65 000 - 95 000; Plein temps

Résumé du poste

The Michigan Department of Health and Human Services (MDHHS) Office of Inspector General seeks a Senior Managed Care Oversight Analyst to review complex Medicaid Managed Care Entities and MI Choice Waiver Agencies for fraud, waste and abuse. You will advise on regulatory changes, develop oversight tools, and conduct annual contract reviews.

Position requires a bachelor’s degree and substantial professional experience in accounting or managed care, with stringent background checks and the ability

Qualifications

• Bachelor’s degree in any major required.
• Three years of professional experience, including one year at the P11 level in state service.
• Preferred experience in accounting, auditing, managed care, and Medicaid or similar health services.

Responsabilités

• Investigates the most complex activities and submissions by Medicaid Managed Care Entities and MI Choice Waiver Agencies for fraud, waste and abuse.
• Advises on interpretation of regulatory changes and develops/updates oversight tools to evaluate program integrity.
• Conducts annual contract reviews and monitors corrective action plans, sanctions and penalties.
• Provides guidance on regulatory changes and state-wide impact of managed care oversight.

Formation

Bachelor's degree in any major

Description du poste

The Michigan Department of Health and Human Services (MDHHS) Office of Inspector General seeks a Senior Managed Care Oversight Analyst to review complex Medicaid Managed Care Entities and MI Choice Waiver Agencies for fraud, waste and abuse. You will advise on regulatory changes, develop oversight tools, and conduct annual contract reviews.

Position requires a bachelor’s degree and substantial professional experience in accounting or managed care, with stringent background checks and the ability