Medicaid Director (Public Service Executive)

Iowa Department of Human Services seeks a professional to lead the Iowa Medicaid Enterprise (IME).  IME is a health care payor that provides comprehensive health care benefits to over 600,000 Iowans annually and has annual expenditures in excess of $ 5.6 billion.  This key critical position serves on the Department’s executive management team.

The Medicaid Director is the primary architect of the strategy that establishes IME’s goals for optimal health outcomes and financial performance. This position defines program objectives and performance measures to ensure goals are attained.  The role requires a superior knowledge of the insurance industry’s healthcare payment systems and CMS regulations, in order to integrate federal mandates into compliant state policy. This pivotal role provides vision and direction for IME staffs and contractors to implement strategies focused on effective delivery results.  The Director must be an effective communicator to craft initiative messages and continually collaborate with a broad and diverse group of stakeholders inclusive of consumers, provider associations, legislators and CMS.

This role is responsible for the integration and performance of the Managed Care Organizations (MCOs) who serve the majority of Iowans in the Medicaid hawk-i and Iowa Health and Wellness Programs. MCOs service approximately 600,000 Iowans with a total budget of approximately $4B. In addition, the Director must continue to meet or exceed performance expectations of the traditional fee-for-service Medicaid programs, while leading aggressive program integrity activities and continually identifying and sourcing redundancies of support systems.

This high profile position sponsors Medicaid initiatives and leads federal waiver(s) and state negotiations for program implementation which includes:  provide member and provider support services, provider claims payment, program integrity actions, implementation of quality physical health care and long term supports and services to ensure members receive quality and integrated services, provision of quality services and program improvement activities, delivery of stated health, behavioral health and long term care outcomes, effective management within a capitated rate, proactive and fair processes for addressing member and provider issues.

This high profile position is located at the state Capitol complex in Des Moines, IA.  Des Moines provides a safe, clean environment with affordable housing, great restaurants, shopping and an international airport.  Please visit:

Candidates must have experience interpreting complex federal and state law; creating and implementing strategic operational plans for a large and multi-faceted organization; proactively and accurately identifying issues while seeking resolutions to meet immediate needs and positioning the agency for future requirements, and finally, the leadership role in negotiation, design and execution of multi-million dollar service contracts emphasizing ‘best practice’ and cost containment.

Minimally, candidates applying for this ‘At-Will’ position must possess seven (7) years of progressively responsible positions within the healthcare, public administration/public policy, finance/accounting or insurance fields. Experience with managed care is preferred. Successful candidate will enjoy a generous benefit package.

Salary commensurate w/experience
$ 94,181 – $ 147,035

For consideration forward resume/vita highlighting experience to:
shase@dhs.state.ia.us

 

AA/EEO

 

AGENCY DESCRIPTION:

The Georgia Department of Community Health (DCH) is one of Georgia’s four health agencies serving the state’s growing population of almost 10 million people. DCH serves as the lead agency for Medicaid and oversees the State Health Benefit Plan (SHBP), Healthcare Facility Regulation and Health Information Technology in Georgia for one in four Georgians.  Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state’s most vulnerable and under-served populations. Six enterprise offices support the work of the agency’s four program divisions. DCH employees are based in Atlanta, Cordele and across the state.

DCH is currently seeking a qualified Assistant Chief, of Performance Quality and Outcomes with the Medicaid Division. 

JOB SUMMARY: 

Plans, develops and directs the Medicaid Quality Improvement functions. Provides leadership necessary to achieve national best practice performance levels in quality improvement.  Ensures that the quality of healthcare services rendered by contracted managed care plans meets or exceeds professionally recognized community standards.  Oversees a diverse range of support, operational, and programmatic activities for the Department of Community Health.  Recommends and implements policies and procedures.  Provides leadership to subordinate managers and staff.  Interfaces with a diverse range of clinical and administrative professionals, resolves sometimes-complex policy and service issues within the group and directs data analytic and reporting activities.  Ensures compliance with state, federal, and accreditation requirements. 

SALARY:

Annual Salary: $75,508.41 – $107,869.16

Pay Grade: Q ((The position may be filled at a higher level based on experience)

Current Georgia state government employees will be subject to SPB rule provisions to salary. 

Click here to Apply

 

The Health Care Authority is seeking a seasoned finance professional with ten plus years of executive leadership experience, especially with regard to managing multiple programs, mentoring and coaching,  dealing with ambiguity, and providing vision and strategic leadership in a public environment. 

The ideal candidate for this important position will also have prior experience in health care finance at a local, regional or national level, and will be adept at cultivating strong stakeholder relations. Desired personal characteristics include strong communication skills, high emotional intelligence, and the ability to work with diverse stakeholder groups and authorizing environments. 

For more information and to apply, please follow the link below:
Chief Financial Officer $120,000 -$150,000 Annually.

 

Health Care Coordinator 2 – Nurse (Announcement #32401)
This position is within the Long Term Support Services (LTSS) Unit of the Division of Health Care Financing and Policy(DHCFP) and is located in Carson City. LTSS supports individuals who need ongoing care due to age, physical or intellectual disability or chronic illness. Incumbent will oversee compliance with Nursing Facilities and Intermediate Care Facilities for the individual with Intellectual Disabilities, and oversee the Medical Behaviorally Complex Care Program. Functions include developing and updating Medicaid policy based on best practices and federal and state statutes, performing trend analysis on specific programs, and ensuring federal compliance. This position will require clinical analysis to monitor quality outcomes and trends of Nursing Facility data, frequent contact with service providers, advisory groups, and recipients including the participation in community and public relations activities to assist with budgetary recommendations, program needs and outreach. The incumbent must be able to work independently and become extremely knowledgeable in all areas of Medicaid.  *** THIS RECRUITMENT MAY CLOSE AT ANY TIME BASED ON THE AMOUNT OF APPLICATIONS RECEIVED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE. *** 

Click here for more information on this position and to apply.

Accountant 1 (Announcement #32420)
This position is located in the Fiscal Services Unit of the Division of Health Care Financing and Policy (DHCFP) in Carson City. The incumbent will be responsible for projecting, monitoring, reviewing, and reporting Medicaid related expenditures. Regular duties will include preparing annual and quarterly federal budgets and reporting actual expenditures for Medicaid related grants. Additional duties will include preparing draw requests for federal grants and related journal entries, reconciling grant activity and processing quarterly cost allocations. This position also interacts with Centers for Medicare & Medicaid Services (CMS) representatives to ensure reporting processes meet current grant requirements and guidelines. The DHCFP works in partnership with CMS to assist in providing quality medical care for eligible individuals and families with low incomes and limited resources. Services are provided through a combination of traditional fee-for-service provider networks and managed care. Travel up to 25% of the time may be required. Audit experience is preferred, but not required. 

Click here for more information on this position and to apply.

Accountant 2 (Announcement #32428)
This position is located in the Fiscal Services Unit of the Division of Health Care Financing and Policy (DHCFP). This position is responsible for preparing monthly reconciliations of Medicaid related data used in federal reports. Duties will include preparing quarterly federal expenditures and budget reports; researching and responding to federal inquiries regarding reported expenditures; monitoring federal grant activity and preparing supplemental requests when necessary; and developing and supervising a systemic reconciliation program for all federal grants to assure amounts recorded in Nevada’s internal system and federal systems match. Travel up to 25% of the time may be required.  

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here for more information on this position and to apply.

 

The Oregon Health Authority is looking for a passionate leader who is eager to influence and advance health system transformation in Oregon, to join our innovative team as the State Medicaid Director.  

This key position is a catalyst in building strong collaborative relationships with public health, behavioral and oral health champions throughout the state. The State Medicaid Director provides overall leadership and direction for strategic program development, health policy and program implementations for the Oregon Health Plan, with an enrollment of over one million individuals.  

We invite you to view additional details about this opportunity in our electronic brochure. 

Please contact Diana Garibay directly via email or by phone 503-840-8090 for additional information.

 

 

The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Deputy Director.  Built on a system of competition and choice, AHCCCS is a $12 billion program that operates under an integrated managed care model, through a Research and Demonstration 1115 Waiver. Contracted health plans coordinate and pay for medical services delivered by over 60,000 health care providers for 1.9 million individuals and families in Arizona.

The Deputy Director reports to the AHCCCS Director and is responsible for the oversight of the administrative and programmatic operations and managing the agency’s fiscal, budgetary, and strategic planning functions.

For more information and to apply, please visit:

https://azstatejobs.azdoa.gov/ltmprod/xmlhttp/shorturl.do?key=20OY

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
Social Services Manager (Announcement 32303)
Location: Carson City, Nevada 

Incumbents function as managers who train, supervise and evaluate the performance of subordinate supervisors; develop policies and procedures; and allocate staff and resources to accomplish goals and objectives. The Social Services Manager III (SSM III) exercises direct control over the operations, implementation and provision of social services for Medicaid programs for Medicaid recipients residing in northern Nevada, including rural counties. This position ensures that program operations are in federal and state regulatory compliance, assuring no loss of services or negative impact from the Federal government in relationship to continued funding and oversight. The SSM III manages three Division of Health Care Financing and Policy (DHCFP/ Medicaid) northern district offices covering sixteen of seventeen Nevada counties, directly supervising licensed Health Care Coordinator (HCC) IVs and HCC III positions. District office staff members are supervised by the manager’s direct reports.

The manager ensures the organization of work units, the duties and responsibilities of subordinates in their work activities, established and maintains a supportive and professional office culture, develops work plans, goals and objectives, develops work performance standards and writes and reviews evaluations, and is also responsible to implement corrective action and discipline, as appropriate; interprets difficult and sensitive problems related to personnel and recipient issues, legislators or the general public who contact the northern district offices; makes recommendations regarding budgetary matters affecting the northern district offices; ensures accuracy of statistical data gathered and reported; and ensures compliance with standards of quality, quantity, and timeliness in accordance with federal regulations, and state laws. District office responsibilities are complex and involve significant health, safety, and welfare issues for recipients. The District offices’ goals of prevention, early intervention and quality of care for eligible individuals are carried out with a focus on community services in a financially responsible manner. Duties include interpretation of difficult and/or sensitive problems related to both personnel issues and those involving recipients, legislators, or the general public. A driver’s license or evidence of equivalent mobility is required at the time of appointment and a condition of continuing employment. Travel to the rural areas for meetings will be required up to 25% of the time.  

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here for more information on this position and to apply.

Management Analyst 3  (Announcement  32298)
Location: Carson City, Nevada

As a member of Division of Health Care Financing and Policy’s (DHCFP/Medicaid’s) Operational Analytics Team, the incumbent will provide data retrieval, reporting, and analytic services to internal customers and external partners and stakeholders; log activity in the department-wide request tracking system; provide fiscal, budgetary, and reporting services for the Health Care Guidance program, a primary care case management initiative; assist with providing data and analyses to the DHCFP’s External Quality Review Organization (EQRO) vendor and the DHCFP’s contracted actuary; assist the team with routine and ad hoc medical claims and demographic reporting and monitoring; develop and maintain dashboards for compliance monitoring; and with necessary training, assume a role as one of the Unit’s Data Warehouse and Decision Support System subject matter experts; and develop and distribute complex queries and reports and train staff in their use for the Unit and the Division.

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

 Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

 Click here for more information on this position and to apply.

 

Management Analyst 4 (Announcement #32330)
Location: Carson City, Nevada 

This position is the leader of the Division of Health Care Financing and Policy’s (DHCFP/Medicaid) Operational Analytics Team; will supervise management analysts and will provide data retrieval, reporting and analytic services to internal customers and external partners and stakeholders; coordinates with Department of Health and Human Services (DHHS) agencies and the Director’s Office analytical assets (economists and analysts) to manage, triage, and log activity in the department-wide request tracking system; assists the team with complex analyses as well as routine and ad hoc medical claims and demographic reporting and monitoring; develops and maintains dashboards for compliance monitoring; has a role as one of the Unit’s Data Warehouse and Decision Support System subject matter experts; develops and distributes complex queries and reports and train staff in their use. 

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here for more information on this position and to apply.

Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.

 

 

DEPARTMENT OF MEDICAL ASSISTANCE SERVICES EMPLOYMENT OPPORTUNITY

This Agency is charged with ensuring proper MEDICAID services to qualified recipients.  Please visit our website and the Commonwealth of Virginia’s website referenced below for additional information and qualifications.

SENIOR PROGRAMS ADVISOR, ELIGIBILITY
Role Title: Program Administration Manager III
Position #:01060
Pay Band 6 Level I Hiring Range $57,342 – $90,000

Closing Date: September 18, 2017

Unique opportunity to provide support to upper level management by developing a new and comprehensive approach to assessing and improving the process and accuracy of determining eligibility for Department of Medical Assistance Services programs. This position will report to the Agency Chief Deputy and will work with a team of agency staff, other state and local staff, and stakeholders/advocates to develop and implement a Quality Measurement program for Medicaid/CHIP eligibility.  Responsibilities will include defining performance standards, developing metrics, collecting data and tracking measures, identifying trends and issues, and developing recommendations and corrective actions to ensure that the eligibility determination process is in compliance with all federal and state regulations and provides a high quality consumer experience. Qualified applicants must have considerable knowledge of large complex governmental organizations, how they are administered and how they intersect at the state and local levels. The position also requires considerable knowledge of human services delivery systems, performance management techniques, qualitative and quantitative data analysis, and philosophies and approaches associated with continuous quality improvement and customer focused service delivery.  Requires experience analyzing complex issues, making recommendations to leadership, preparing decision briefs and presentations, and implementing new policies and procedures.  Must have proven ability to manage complex projects and multiple priorities, set goals, develop multi-level work plans and strategies, and monitor progress to complete time sensitive assignments with minimal direction.  Must have demonstrated ability to lead others with diverse interests and to build collaborative relationships with various stakeholders/advocates, state and local agency staff, and high-level decision makers to achieve consensus and results. Experience with performance/quality metrics is strongly preferred. Experience developing new and complex initiatives involving a broad range of stakeholders is also preferred. Knowledge of eligibility processing for Medicaid/CHIP and/or human service programs would be advantageous.  Graduation from an accredited college or university with major course work in health, business or public administration, public policy, or relevant field preferred; master’s degree in relevant field preferred.

ONLINE STATE APPLICATION REQUIRED
Resumes will not substitute for state applications.  DMAS will only accept online applications submitted through the RMS by 11:59 p.m. on the referenced closing date.  Faxed, emailed, or hand delivered applications or resumes will not be accepted and resumes will not substitute for a complete state application.  Applications must include complete work history, including periods of unemployment if applicable.  Consideration for an interview is based solely on the information within the application.

Receptionist: 804-786-5408, TDD 800-343-0634
Web Sites for Vacancy Listings
RMS: https://virginiajobs.peopleadmin.com/
DMAShttp://www.dmas.virginia.gov/Content_pgs/ab-emp.aspx

Applicants who require accommodation to apply for Agency openings should contact the DMAS receptionist for assistance.
EEO/AA/ADA

 

The Wisconsin Department of Health Services, Division of Medicaid Services (DMS) is currently recruiting to fill an Associate Director of Operations (Health Services Associate Manager) position in the Bureau of Milwaukee Enrollment Services (MilES). This important executive leadership position offers competitive pay and a top-rate benefits package.

Under general supervision of the Director of MilES, the Milwaukee Enrollment Services (MilES) Associate Bureau Director is responsible for directing, coordinating, planning, monitoring and evaluating the operational activities of MilES staff and the functions required to meet all operational and programmatic priorities, goals, and objectives within this high volume call center and case management environment. Under the direction of the Bureau Director, this includes the areas of general operations, human resources, IT, and administrative support as well as providing expertise and coordination of policy development and implementation, management, and other services required for the effective and efficient management of the Bureau. The MilES Associate Director is also responsible for fostering positive community relationships within the greater Milwaukee area and working with community partners.

To see full posting click here.

 

The Washington State Health Care Authority (HCA) is seeking an entrepreneurial leader with knowledge and expertise of the health care market and landscape to foster the vision of a Healthier Washington.

The Chief Policy Officer will ensure infusion of Healthier Washington functions into the business of the agency, sustainability of innovation, and positioning to leverage market opportunities for the benefit of the two million Washington lives insured by HCA.

For more information, follow the link below:

Chief Policy Officer $115,000 – $150,000 Annually.
HCA Chief Policy Officer Recruitment Announcement.

 

About the National Association of Medicaid Directors (NAMD)
The National Association of Medicaid Directors (NAMD) seeks a Program Director to primarily oversee and support its growing Medicaid leadership portfolio, along with other initiatives.

NAMD is a bipartisan, nonprofit, professional organization representing leaders for state Medicaid agencies across the country. Our members drive major innovations in health care while overseeing Medicaid, one of the nation’s most vital health care programs, which covers more than 74 million Americans. NAMD was established in 2011.

NAMD’s mission is to support Medicaid Directors in 1) administering their programs in cost-effective, efficient and visionary ways; and 2) enabling Americans served by Medicaid to achieve their best health status and to thrive in their communities.

NAMD is a small association and supports Medicaid Directors by:

  1. Offering programs that connect Medicaid Directors to their peers and resources for problem-solving, exchanging lessons learned, and advancing innovations; and that provide leadership training to Medicaid Directors and their teams; and that advances the profession of state Medicaid Directors;
  2. Providing Medicaid policy strategy and analysis, including developing and communicating consensus positions at a national level; and fostering a strong and equal state-federal partnership; and
  3. Serving as the trusted source for data and information about Medicaid Directors.

Available Position: Program Director for Medicaid Leadership
The Program Director will oversee and support NAMD’s investments in leadership and professional development for Medicaid Directors and their teams. Although leadership is not a new area for NAMD, the median tenure for Medicaid directors remains at 19 months, suggesting that this is a highly challenging and difficult job prone to burn out and turnover. Given the critical leadership role Medicaid Directors play in every state – Medicaid can cover up to 30% of a state’s residents, and 25% of the state’s budget – the loss of momentum, historical knowledge, strategy, vision that often results from high turnover at senior levels, NAMD and its board of directors are committed to enhancing, expanding and “democratizing” investment in Medicaid leadership and succession planning.

The primary responsibility of the program director is to create a year-round program that offers multi-faceted leadership training for state Medicaid teams, including a mix of in-person events and virtual meetings; trainings geared toward teams, managers, and new Medicaid Directors; a mix of content and topics related to leadership; strategic communications around the portfolio; and other items. He/she will strive to keep the program and resources fresh, effective, varied, and always relevant to Medicaid Directors and their teams.

This individual is not expected to deliver or teach leadership content, although depending on skill and background, he/she could do some of this. The expectation is that the program director would leverage national or state experts for knowledge and skills for content and delivery. In other words, this is a role for design, development, management and coordination.

Although this position is built primarily around leadership, the successful candidate will have a strong background in health care policy and Medicaid. This is for two reasons. Medicaid, health care, and policy impact everything NAMD does, and to be effective, the Program Director must already be well-steeped in these issues. Second, the leadership program will be offered within the context of topics such as leading effective managed care contracting, building effective partnerships with advocates, and forming a strong partnership with CMS. In other words, some leadership resources will be built around Medicaid content.

The Program Director will report to the Deputy Executive Director and work closely with her on NAMD’s program portfolio and a related sustainability strategy. Business development will be an important aspect of this position. For example, this individual will be responsible for developing concept papers, grant proposals, and ultimately manage grants for the leadership portfolio. He/she will also work with the Deputy Executive Director and Operations Director on planning, budgeting, and financing the portfolio.

The Program Director will responsible for communications related to the leadership portfolio, including outreach to and engagement of the Medicaid Directors and teams; internal communication with the NAMD team regarding strategy and events; and external communications about NAMD’s program and efforts.

The Program Director will have staff support as needed to help with coordination of events, research of issues, tracking of tools and information, scheduling of events, and meeting planning.

Lastly, the Program Director will become part of a small but committed team of health policy analysts and fervent supporters of and advocates for Medicaid Directors. As part of the team, the program director will help develop annual NAMD meetings, sharing insights and ideas from his/her program area.  

Responsibilities

  • Design, implement and expand NAMD’s leadership portfolio and related products for Medicaid Directors and their teams
  • Manage projects and technical assistance
  • efforts for states around Medicaid leadership and related issues
  • Facilitate state-to-state learning opportunities through a variety of forums and outlets
  • Coordinate and collaborate with other relevant organizations and keep abreast of emerging issues
  • Assess, understand and keep track of the existing landscape of Medicaid leadership, including building a stable of national experts, identifying available resources, and other programs
  • Develop and update an online directory of leadership resources and tools available to Medicaid Directors and their teams
  • Evaluate the impact of NAMD’s leadership program and products, making adjustments for continual improvement and effectiveness per feedback of the Medicaid Directors
  • Develop effective written and verbal communications – to both internal and external audiences – related to NAMD’s leadership program and products
  • Develop tools such as webcasts, podcasts, issue briefs, blog posts, newsletters, and other vehicles for providing information
  • Develop, secure and manage philanthropic funding for leadership program and products
  • Respond to member requests and concerns related to this program area
  • Collaborate with the NAMD team when events, funders, topic areas, states or Medicaid Directors overlap
  • Manage and develop a program analyst

Requirements 

  • Strong foundation of knowledge in state health policy issues, particularly regarding the Medicaid program
  • 4-6 years work experience in relevant positions, at the state or national level
  • Masters degree preferred, but additional relevant work experience may be considered equivalent
  • A passion for learning programs and information exchange
  • Intellectually curious, present, and an effective listener
  • Excellent writing skills with the ability to communicate complex ideas in concise manner
  • Strong project management skills and capacity to self-direct workflow
  • Ability to work in a cooperative, team-oriented environment and to network with a wide-range of stakeholders

This is a full-time position located in Washington, DC. Salary is negotiable and commensurate with experience: estimated range of $90,000 to $110,000.  No phone calls, please. 

To Apply
Send resume and cover letter to:
Tess Moore, Operations Director
National Association of Medicaid Directors
Tess.moore@medicaiddirectors.org

 

August 9, 2017 – Nevada – Administrative Services Officer 1 and Health Care Coordinator 1 Bilingual Spanish/English

Administrative Services Officer 1 (Announcement #32200)
Location: Carson City, Nevada 

This position is located in the Fiscal Services Unit of the Division of Health Care Financing and Policy (DHCFP / Medicaid) and performs all of the tasks consistent with the classification series. This position is tasked with critical functions including implementing, maintaining and monitoring federal and state reporting financial operations as well as grants management. This position is primarily responsible for conformance with state and federal accounting laws and regulations. The position acts as a primary liaison with the federal partners and the Nevada State Controller’s Office, and is responsible for resolving complex accounting issues and determining accounting treatment and transaction flow of new transaction types. The position directly supervises one position and indirectly supervises two additional positions.

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

Click here for more information on this position and to apply.

Health Care Coordinator 1 – Bilingual Spanish/English (Announcement #32199)
Location: Las Vegas, Nevada 

This position is with the Department of Health and Human Services in the Division of Health Care Financing and Policy (DHCFP / Medicaid) and is located in the Care Coordination Unit at the DHCFP Las Vegas District Office. This position requires less than ten percent of time travelling within the Las Vegas District Office catchment area. Health Care Coordinators (HCC’s) evaluate individuals referred to the medical services program and provide ongoing case management services to Medicaid eligible clients; evaluate the need for medical services, treatment, equipment, and supplies and authorize payment; screen individuals to determine appropriate level of care in nursing homes; review programs and participate in program development. The Health Care Coordinator in this position uses multiple databases to research recipient data, eligibility information, and computer system interface issues. This position will assist the staff on the customer service phone lines to provide the recipient information regarding benefits and to troubleshoot complicated access to care issues. The position is part of a team of dedicated staff working to ensure services provided by the unit attain goals of prevention, early intervention and quality of care for eligible individuals and offers a family-friendly schedule.

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here for more information on this position and to apply. 

 

August 8, 2017 – Nevada – Auditor 1

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
Auditor 1 – Underfill for Auditor 2 (Announcement #32154)
Location: Carson City, Nevada

This position is an Auditor 1 under fill for an Auditor 2 in the Fiscal Integrity Unit of the Division of Health Care Financing and Policy (DHCFP) and may require as much as 25% of travel. This position reviews and monitors Patient Trust Fund audits performed by Contractor CPA firms to ensure that deficiencies regarding fund management are corrected in a timely manner by Nursing Facilities and Intermediate Care Facilities for individuals with intellectual disabilities. The auditor will participate as a team member in the DHCFP Internal Control Self-Assessment Questionnaire (SAQ) to ensure internal controls are adequately documented in written procedures, sample transactions, and key staff performance in order to minimize the risk of fraud, waste or abuse to division and state assets. This position will assist in the performance of the Change Management Audits of hours charged by the Fiscal Agent Contractors to plan and execute Production Deficiency Requests to change or improve the Medicaid Management Information System and new interchange system in accordance with the terms and conditions of the contract and the Change Management Plan of Operation. This position will be responsible for assisting in monitoring and tracking internal and external audits and corrective action plans and audits, reviews and conducts assessments in accordance to DHCFP guidelines, Generally Accepted Government Auditing Standards, and Generally Accepted Accounting Principles. The ideal candidate will demonstrate the ability to consider all pertinent facts, knowledge and experience in order to make objective decisions and recommendations, and communicate with providers and other health care agencies; possess the ability to read and interpret contracts, policy and procedures, and state and federal laws, regulations and guidelines; and perform work accurately with minimal or no errors.  **THIS RECRUITMENT MAY CLOSE PRIOR TO THE POSTED CLOSING DATE DEPENDING ON THE AMOUNT OF APPLICATIONS RECEIVED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE.**

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here for more information on this position and to apply.
Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada

 

The Fiscal Research Division (FRD) seeks dynamic individuals with strong analytical skills who excel under pressure. FRD analysts are non-partisan and service as the primary budget and finance staff to the North Carolina General Assembly’s 170 members as well as its funding and policy committees.

For this position, preference will be given to applicants who have extensive training, experience, and familiarity with healthcare, managed care, Medicaid/Medicare, social services, public health, and/or mental health programs at either the state or local level.  See full posting for details below.

Fiscal Analyst I – Medicaid

 

Director of Medical Services (DMMA)

This position is exempt from the State of Delaware Merit System
Recruitment #072617-MUDB09-350200

https://www.jobaps.com/DE/sup/BulPreview.asp?R1=072617&R2=MUDB09&R3=350200

Opening Date: 8/1/2017
Closing Date: 8/22/2017 11:59:00 PM
Type of Recruitment: Open Competitive
Salary: Yearly – $155,650/Min. – $172,000
Salary Plan: SMV
Pay Grade: D22
Shift Hours: 8:00am – 4:30pm
Employment Type: Actual Vacancy
Employment Term: Regular
Agency: DHSS/Medicaid and Medical Assistance
Location(s): Herman Holloway Campus (1901 N DuPont Hwy, New Castle, DE, 19270
Contact Name: DHSS Applicant Services
Contact Phone: 302-255-9100

Go Back
Click HERE to apply
Click HERE to view benefits

 

Summary Statement

The Director of Medical Services reports to the Division Director and in collaboration with the Office of the Secretary on health reform. The incumbent in this position will lead statewide clinical innovation efforts in Medicaid for the state and will collaborate with the Medicaid Director on key strategic efforts to move toward value based payment reform.  Additionally, the Director is responsible for the oversight of clinical guidelines, procedures, standards and controls of the Delaware Medicaid Program.

Preferred Qualification

Applicants who do not possess the preferred qualification will still be eligible to compete for this position if job requirements are met.

  1. Experience in leadership at the national level in policy and legislative affairs.
  2. Experience in leadership and the ability to work with physician organizations and clinical audiences.
  3. Clinical experience in Medicaid populations and ability to make clinical decisions.
  4. Experience in projecting, assessing, evaluating and measuring effective service delivery to meet goals and objectives of the Medicaid program.
  5. Experience in establishing and maintaining effective working relationships with all stakeholders in the Medicaid program, including interest groups, health care providers, community members, national organizations and professional groups.
  6. Experience in Grant writing and policy/data analysis.
  7. Experience supervising a team of both clinical and non-clinical staff.
  8. Experience exercising judgment and discretion in applying and interpreting policies, procedures, regulations, standards and protocols.
  9. Knowledge of value based payment, population health, and social determinants of health.
  10. Knowledge of specific federal Medicaid rules, policies, procedures, and regulations to meet matching requirements.
  11. Knowledge and/or experience with diseases, treatments, diagnostics and decision-making, along with finance, grants, contracts, budgeting and accounting for medical decision-making.
  12. Knowledge of community, private, public, state and National health resources and program goals, objectives and funding sources.
  13. Knowledge of State legislative initiatives impacting health policy and delivery systems.

Essential Functions

Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here.

  • Allocates 100 percent of his/her time to Medicaid-related issues. • Plays a pivotal role in clinical affairs, policy and strategic endeavors within Medicaid.
  • Represents the department and leverage relationships in direct engagement with Medicaid’s Managed Care Medical Directors, and collaborates and consults with the Medicaid Director and Deputy as well as program directors and managers across DHSS.
  • Guides and reviews program evaluation and implementation plans while coordinating across state agencies and private organizations providing similar services.
  • Using models from state-led innovations across the county, works collaboratively within DMMA, across DHSS and with the Office of the Secretary to formulate payment policy, delivery system innovations and coordinates the activities for various services within the program.
  • Along with the Delaware Health Care Commission, and stakeholder groups, works with clinical and community based initiatives to have population based metrics of quality and data-driven performance indicators.
  • Lead the development and implementation of medical policy coverage decisions for Medicaid recipients. Works with the medical directors of the agencies managed care organizations to resolve recipient issues. Develops quality measures and outcome measures to support the states’ purchasing efforts. Represents the State of Delaware at the Office of Administrative Hearings and represents the Program at internal and external meetings.
  • Reviews and approves all applicants for the Disabled Children’s Program.
  • Represents DMMA on local, state and national review boards, committees and conferences at the direction of the Division Director.  Provides expertise on medical policies and procedures for staff in DMMA and our sister divisions. Analyzes data and makes recommendations for medical policy changes related to Medicaid, and keeps abreast of legislative and technical developments related to program services.

Job Requirements

Please attach a resume with your online application or use the resume tab in DEL to provide a detailed description of how your education, training and/or experience meets each job requirement and preferential requirements including employer, experience/responsibilities and dates (month/year) of employment/training. Applicants must have education, training and/or experience demonstrating competence in each of the following:

  1. Must be a board-certified medical doctor and hold a current Delaware license.

Benefits

To learn more about the comprehensive benefit package please visit our website at http://ben.omb.delaware.gov/

Selection Process

The application and resume are evaluated based upon a rating of your education, training and experience as they relate to the job requirements of the position.  It is essential that you provide complete and accurate information on your application and resume to include dates of employment, job title and job duties.  For education and training, list name of educational provider, training course titles and summary of course content.   Narrative information supplied in response to the questions must be supported by the information supplied on the application including your employment, education and training history as it relates to the job requirements.

Once you have submitted your application on-line, all future correspondence related to your application will be sent via email.  Please keep your contact information current.  You may also view all correspondence sent to you by the State of Delaware in the “My Applications” tab at www.delawarestatejobs.com.

Accommodations

Accommodations are available for applicants with disabilities in all phases of the application and employment process.  To request an auxiliary aid or service please call (302) 739-5458. TDD users should call the Delaware Relay Service Number 1-800-232-5460 for assistance.  The State of Delaware – An Equal Opportunity and Affirmative Action Employer.

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
Administrative Services Officer 1  (Announcement 32114)
Location: Carson City, Nevada 

This position is located in the Fiscal Services Unit of the Division of Health Care Financing and Policy and is tasked with critical functions including implementing, maintaining, and monitoring federal and state reporting, financial operations as well as grants management. This position is primarily responsible for conformance with state and federal accounting laws and regulations and acts as a primary liaison with the federal partners and the Nevada State Controller’s Office. The position is responsible for resolving complex accounting issues and determining accounting treatment and transaction flow of new transaction types and directly supervises one position and indirectly supervises two additional positions. 

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here for more information on this position and to apply. 

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of: 

SOCIAL SERVICES CHIEF 3  (Announcement 32109)
Location: Carson City, Nevada 

This position is located in Policy Development and Program Management Unit of the Division of Health Care Financing and Policy (DHCFP/Medicaid), overseeing hospitals and clinics and reports to the Deputy Division Administrator. The position is responsible for developing statewide policy for Inpatient/ Outpatient hospitals, Federally Qualified Health Centers, Rural Clinics, Laboratory, Radiology, and Physician Services for Nevada Medicaid and Nevada Check Up programs and oversees professional and paraprofessional State staff as well as utilization management contracts. Major responsibilities include oversight of the development, implementation and maintenance of statewide clinical policies, utilization management practices, key performance indicator reports and state plan, policy and procedure documentation, working with the medical community to determine best practice standards and assure access to quality care and development, implementation and monitoring of legislative budgets. The incumbent will serve as a liaison to key stakeholders, federal/state partners and congressional delegates. Drivers license or equivalent mobility and national and statewide travel is required in order to work with stakeholders. 

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities. 

Click here  for more information on this position and to apply.

Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.

 

The Arkansas Department of Human Services (DHS) is the state’s largest agency with 7,500 employees working in 86 county offices serving more than one million people. Employees work in 11 major divisions and five support offices headquartered in Little Rock to provide services to Arkansans. DHS is seeking to fill a Director of Medical Services position in Little Rock, AR.

The Director of Medical Services works under administrative direction of the Department of Human Services (DHS) Director for the Division of Medical Services (DMS), and is responsible for directing operations of the State Medicaid programs by developing and establishing work priorities, standards of performance, reviewing and approving managerial decisions, and monitoring budgetary needs and expenditures for the Division. The Director of Medical Services is the State Medicaid Director as recognized by the federal financing agency, the Centers for Medicare and Medicaid Services (CMS), and is the primary liaison with CMS, the Legislature, the Governor’s Office, approximately 27,000 Medicaid providers, provider associations, professional associations, as well as other State Medicaid Directors.

This position:

Develops and reviews Medicaid operating and program policies and procedures, reviews and evaluates programs and services with departmental leaders, and makes recommended changes as necessary.

Plans and directs state Medicaid activities by establishing goals, objectives, and short or long-range plans to ensure consistency with overall agency goals.

Monitors DMS budget, reviews and approves expenditures, advises management of potential budget issues, and makes recommendations, including assuring that the state Medicaid budget is correctly forecast and that appropriation and funding is received in the correct categories.

Gathers data and researches technical information for monthly reports, studies and presents to appropriate authorities, and assures that Medicaid data is used to inform research and decisions in many areas within and outside DMS, including CMS, DHS, and other state agencies, hospitals, associations, etc.

Provides Medicaid technical assistance, guidance, and information to internal and external agency contacts, legislators, vendors, and other customers by researching and interpreting federal and state laws, along with agency policies and procedures.

Represents Medicaid in meetings, discussions, and negotiations with individual Medicaid providers as well as provider organizations which represent some of the more than 32,000 enrolled providers.

Works with other DHS divisions on common initiatives.

Oversees the Office of Long Term Care that includes nursing home survey and certification and licensing functions, which are unique among state Medicaid programs and requires specialized knowledge.

Conducts and attends meetings, conferences, and/or workshops to disseminate technical information relating to Medicaid practices and plans.

Coordinates activities with other state and federal personnel, responds to requests for information from executive and legislative officials, and serves on committees or task forces to express ideas and needs or provide recommendations/solutions.

Responds to media requests about Medicaid programs, providers, and other issues through the DHS Communications Office.

Directs the activities of a professional and administrative support staff through lower level managers including interviewing applicants, approving hire recommendations, and evaluating and reviewing work performance of incumbents.

Performs other duties as assigned.

MINIMUM QUALIFICATIONS

The formal education equivalent of a bachelor’s degree in special education, social work, rehabilitation science, management, health service administration, or a related field; plus nine years of experience in the planning, monitoring, analysis, and evaluation of human services or health care programs and operations, or a related field, including three years in a professional managerial capacity. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management.

PREFERRED QUALIFICATIONS

Must possess strong executive leadership skills with strengths in organizational development and management innovation. Experience with financial management, cost control, quality service improvement and change initiatives. High level experience working with Medicaid.

Prefer 12 years of progressively more responsible experience in Medicaid, including 6 years in a professional management capacity.

Position number: 22143293
Closing date: July 02, 2017

APPLY ONLINE AT

https://www.ark.org/arstatejobs/index.php?ina_sec_csrf=dc6a14e8b2819b8f65cd0925b393fb3b&ac:show:show_job=1&agencyid=104&jobid=92197

 

We are conducting an executive search for a dynamic Chief Information Officer (CIO) with exceptional managerial skills to lead the IT function of the Department of Health and Mental Hygiene (DHMH) for the State of Maryland. This high-profile position is empowered to provide technology vision and leadership in the development and implementation of vital initiatives in support of the Department’s mission. This position is strategic as well as tactical in aligning IT business objectives with the entire department and delivering change management.

See full posting here.

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
IT Professional 4 – Information Security Officer/Manager IT Operations (Announcement Recr. #31693)
Location: Carson City, Nevada

This position is located in the Information Services section of the Division of Healthcare Financing (DHCFP / Medicaid) and Policy in the Department of Health and Human Services located in Carson City. This position serves as the Manager of the IT Operations team and the Division Information Security Officer (ISO) with direct supervisory responsibility of four IT Professional III positions, in addition to indirect supervisory responsibility for two IT Tech VI (one of which is located in Las Vegas) positions and one IT Tech V position. The incumbent will report directly to the Chief of Information Services. The incumbent will be subject to occasional callback and evenings and weekends work. *** THIS RECRUITMENT MAY CLOSE AT ANY TIME BASED ON THE AMOUNT OF APPLICATIONS RECEIVED. QUALIFIED APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE. ***

 The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

 Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

Click here for more information on this position and to apply.

Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.

 

Functional Job Title:   Medicaid Attorney
Grade:                         N904
Position No.                22097600

CLASS SUMMARY
The Medicaid Attorney is responsible for providing professional legal counsel and administering legal services for the Arkansas Medicaid program. This position is governed by state and federal laws and agency/institution policy.

TYPICAL FUNCTIONS
Serves as the legal resource for the agency in day to day Medicaid activities and interactions that occur in the normal course of business of the agency. Advises agency management on potential Medicaid issues affecting the agency and offers legal opinions on actions the agency may take in resolving Medicaid legal issues. Represents the agency in legal proceedings which may occur in state or federal courts. Drafts proposed legislation, amendments to current legislation, amendments to Medicaid and agency regulations, and represents the agency at legislative hearings. Coordinates with the Attorney General’s Office to prepare responses to requesting parties seeking documents and records under the Freedom of Information Act (FOI). Performs other duties as assigned.

SPECIAL JOB DIMENSIONS
Occasional in-state travel to attend fact finding meetings, hearings, and/or court proceedings is required. Occasional out of state travel related to agency legal matters may be required.

KNOWLEDGES, ABILITIES, AND SKILLS
Knowledge of state and federal laws. Knowledge of the state’s legislative processes. Knowledge of litigation practices and procedures. Knowledge of Medicaid Title 18 & 19. Knowledge of Medicaid finance administration, eligibility, benefits and service delivery. Ability to research, analyze, interpret, and apply case law, state and federal statutes, legal precedents, and relevant legislative intent to agency legal matters. Ability to provide legal guidance and technical assistance to agency management. Ability to establish and maintain cooperative working relationships with agency staff and other relevant legal and agency contacts. Ability to communicate across all levels of the agency. Ability to conduct complex litigation.

MINIMUM QUALIFICATIONS
The formal education equivalent of a law degree from an accredited law school; plus five years of experience in public sector law including 2-3 years of Medicaid experience and two years of litigation experience. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.

CERTIFICATES, LICENSES, REGISTRATIONS
Licensed to practice law and admitted to the Arkansas State Bar per ACA 16-22-201.

Specific / Preferred Qualifications

  1. Law degree from an accredited law school.
  2. Licensed to practice law and admitted to the Arkansas State Bar.
  3. Five years of experience in public sector law.
  4. 2-3 years of Medicaid law experience.
  5. 2-3 years of litigation experience.
  6. Knowledge of the State of AR’s legislative processes.
  7. 2-3 years’ experience with Medicaid Title XIX
  8. 2-3 years’ experience with Medicaid finance, administration, eligibility, benefits and service delivery.

Apply by emailing dhs.recruiting@arkansas.gov. The deadline to apply is July 2, 2017.

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the positions of:

1. Health Care Coordinator 2 – Nurse (Announcement Recr. #31674)
Location: Carson City, Nevada

The position is located in Carson City, NV. This position is responsible for the development, implementation, management and evaluation of the medical coverage policies and procedures for the Inpatient Hospital program. The incumbent will be required to research/analyze federal and state regulations and other best practices. The incumbent will be required to work with contractors, providers, and other stakeholders to perform education and outreach on policies and procedures and is required to manage tasks in an independent manner.

Click here for more information on this position and to apply.


2. 
Health Care Coordinator 2-RN  (Announcement 31601)
Location: Carson City, Nevada 

This position is located in Carson City, NV. This position is responsible for the development, implementation, management and evaluation of the medical coverage policies and procedures for the Pediatric Inpatient Hospital and Dental Programs. The incumbent will be required to research/analyze federal and state regulations and other best practices. The incumbent will be required to work with contractors, providers and other stakeholders to perform education and outreach on policies and procedures. The position is required to manage tasks in an independent manner.

Click  here  for more information on this position and to apply.


3
. Health Care Coordinator I Nurse (Announcement 31619)
Location: Las Vegas, Nevada

This position is with the Department of Health and Human Services in the Division of Health Care Financing and Policy (DHCFP) and is located at the DHCFP Las Vegas District Office. This position requires less than fifty percent of time travelling within the Las Vegas District Office catchment area. Health Care Coordinators (HCC’s) evaluate individuals referred to the medical services program and provide ongoing case management services to Medicaid eligible clients; evaluate the need for medical services, treatment, equipment and supplies and authorize payment; screen individuals to determine appropriate level of care in nursing homes; review programs and participate in program development.

Click  here  for more information on this position and to apply.

 

4. Health Care Coordinator 2  (Announcement  31649)
Location: Las Vegas, Nevada

This position is with the Department of Health and Human services in the Division of Health Care Financing and Policy (DHCFP) and is located at the Las Vegas District Office. This position requires less than fifty percent of time traveling within the Las Vegas District Office catchment area. Health Care Coordinators (HCC’s) evaluate individuals referred to the medical services program and provide ongoing case management services to Medicaid eligible clients; evaluate the need for medical services, treatment, equipment, and supplies and authorize payment; screen individuals to determine appropriate level of care in nursing homes; review programs and participate in program development.

 Click  here  for more information on this position and to apply.

5. Health Care Coordinator 1  (Announcement 31651)
Location: Las Vegas, Nevada 

This position is with the Department of Health and Human Services in the Division of Health Care Financing and Policy (DHCFP) and is located at the Las Vegas District Office. This position requires less than fifty percent of time traveling within the Las Vegas District Office catchment area. Health Care Coordinators (HCC’s) evaluate individuals referred to the medical services program and provide ongoing case management services to Medicaid eligible clients; evaluate the need for medical services, treatment, equipment and supplies and authorize payment; screen individuals to determine appropriate level of care in nursing homes; and review programs and participate in program development.

Click  here for more information and to apply.

6. Health Care Coordinator 2-Bilingual Spanish/English
Location: Las Vegas, Nevada

This position is with the Department of Health and Human Services in the Division of Health Care Financing and Policy (DHCFP) and is located in the Care Coordination Unit at the Las Vegas District Office. This position requires less than ten percent of time traveling within the Las Vegas District Office catchment area. Health Care Coordinator (HCC’s) evaluate individuals referred to the medical services program and provide ongoing case management services to Medicaid eligible clients; evaluate the need for medical services, treatment, equipment and supplies and authorize payments; screen individuals to determine appropriate level of care in nursing homes; review programs and participate in program development. Health Care Coordinators in this position use multiple databases to research recipient data, eligibility information, and computer system interface issues. This position will assist the staff on customer service phone lines to provide the recipient information regarding benefits and to troubleshoot complicated access to care issues. Applicants must be bilingual in both Spanish and English.

 Click  here  for more information on this position and to apply.

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.

 

 

The Nebraska Division of Medicaid & Long Term Care is seeking a Director of the Division. The position is responsible for charting the agency’s path through the dynamic health industry landscape. Works directly with the Governor and the Chief Executive Officer of the Department of Health and Human Services to set policy for the division that optimizes service delivery, patient experience, and fiscal stewardship.

Full announcement and application here.

 

The DC Department of Health Care Finance is seeking a Supervisory Policy Analyst who will serve as the Associate Director for the Division of Regulations and Policy Management within the Health Care Policy and Research Administration at DC’s Medicaid agency, the DC Department of Health Care Finance.  We are seeking an attorney with Medicaid work experience who has some background in rulemaking (and ideally State Plan work) and some supervisory experience.  This person will supervise a team of 5 to manage our SPA and rule work.  More information on the positon can be found here: http://careers.dc.gov/ts2__JobDetails?jobId=a0K1600000kCi1bEAC&tSource=   

 

The South Carolina Department of Health and Human Services is seeking qualified candidates for the position of Director of Program Integrity and Surveillance Utilization Review System (SUR) programs. The program director will oversee the management of provider and beneficiary investigations and reviews to identify areas of misuse, fraud, abuse, and incorrect payments. The program director will also develop policies and procedures to guide program operations and ensure coordination between Program Integrity and other divisions within the agency. This position will be responsible for all managerial administrative functions for the program, including budgeting, drafting contracts when needed, ensuring appropriate training for staff and coordinating the agency’s response(s) to Program Integrity audits conducted by federal agencies such as the Centers for Medicare and Medicaid Services (CMS) and state agencies such as the Office of the State Auditor (OSA).  

Qualified candidates must have a bachelor’s degree and  five (5) years of management experience with Medicaid, Medicare, and/or other health care payers, and  five (5) years of direct Program Integrity and/or Healthcare Special Investigative Units management experience. Must have and maintain a valid driver’s license. 

For more information and to apply, please visit: jobs.sc.gov.

 

DIRECTOR OF ELIGIBILITY AND ENROLLMENT
Role Title: General Administration Manager III
Position: #00128
Pay Band 7, Hiring Range: $72,731 –$125,000

Closing Date: June 5, 2017

Exciting opportunity to provide executive leadership and direction for the Division of Eligibility and Enrollment Services within the state Medicaid agency. This position directs all operations, programs, policy, and staff within the division, including oversight of Eligibility Policy, Eligibility Operations and Performance Management. This position also serves as the Commonwealth’s Children’s Health Insurance Program (CHIP) Director with primary responsibility for oversight of the FAMIS and FAMIS Moms programs. Qualified applicants must have considerable knowledge of the Medicaid and CHIP programs, including the history, policies, regulations, major initiatives, and the populations served. We are seeking a strong manager with recent experience directing the work of professional employees, developing high performing teams, setting goals, and managing resources to achieve results. The successful candidate must have the ability to communicate orally and in writing and to serve as an effective spokesperson for the agency as well as have a history of successful experience working collaboratively with diverse stakeholders toward the achievement of shared goals. Experience utilizing data to formulate proposals, revise procedures, evaluate programs, measure performance, and improve outcomes is also necessary. Preferred qualifications include: knowledge of Medicaid/CHIP eligibility policies and related IT systems; the budgetary, contract management and regulatory processes of Virginia state government; and experience with the legislative process at the state or federal level. An advanced degree in a relevant field is preferred. This position is subject to a criminal history background check. Pursuant to Sections 2.2-3115 and 2.22-3115 of the Code of Virginia, this position has been designated to file a Statement of Economic Interests Form at the time of employment and semi-annually thereafter.

To apply, follow the link below:

https://jobs.agencies.virginia.gov/applicants/jsp/shared/position/JobDetails_css.jsp?postingId=1175978

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
Health Care Coordinator 2 – Nurse (Announcement Recr. #31427)
Location: Carson City, Nevada

This position is located in Carson City, NV. This position is responsible for the development, implementation, management and evaluation of the medical coverage policies and procedures for the Pediatric Impatient Hospital and Dental Programs. The incumbent will be required to research/analyze federal and state regulations and other best practices. The incumbent will be required to work with contractors, providers and other stakeholders to perform education and outreach on policies and procedures. The position is required to manage tasks in an independent manner.

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

Click here for more information on this position and to apply.

 Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
Health Care Coordinator 2 (Announcement 31434)
Location: Las Vegas, Nevada

This position is located in the Las Vegas Medicaid District Office within the Division of Health Care Financing and Policy. Incumbent will perform Person Centered Planning and Case Management activities to comply with Centers for Medicare/Medicaid; and State of Nevada Home and Community Based Services (HCBS) regulations. This position monitors quality outcomes and trends of HCBS and will have frequent contact with service providers, advisory groups, and recipients. This position will also be responsible for the development and implementation of policy and procedures to maintain continuous quality improvement. The incumbent must be able to work independently and become extremely knowledgeable in all areas of Medicaid. 

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees. 

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

 Click  here for more information on this position and to apply.

Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.

 

 

 

 

The Georgia Department of Community Health (DCH) is currently seeking an Assistant Chief for the Medicaid, Member Services and Policy Unit. 

Job Summary:

Medical Assistance Plans functions as a division within the Department of Community Health.  It receives 15 percent of the state’s budget to ensure vital healthcare coverage to approximately 1 in 5 Georgians, serving almost 2 million beneficiaries.  This position directs the eligibility policy functions of for Medicaid and works closely with the Division of Family and Children’s Services (DFCS) who renders eligibility determinations for the State of Georgia.  This position helps DCH achieve its mission by aligning eligibility policy with agency goals, promoting inter-divisional and inter-agency collaboration, and ensuring compliance with state and federal laws and regulations.

Oversees a diverse range of support, operational, and programmatic activities for a department, agency or facility. Recommends and implements policies and procedures. Provides leadership to subordinate managers and staff.

Full posting can be found here.

 

 

The State of South Dakota is looking for a passionate expert to bring your Medicaid expertise to help us shape healthcare for our citizens. Use your combined knowledge of the State Medicaid program with a desire to serve the most vulnerable populations with quality healthcare programs. Your success innovating and leading states’ programs that optimize processes to enable agency success and performance will be important. We need a progressive leader that helps us think, lead and deliver with outcomes in mind. You can be the difference for the people of South Dakota.

See full posting here.

 

 

The State of Nevada Division of Health Care Financing and Policy is seeking qualified candidates for the position of:
Health Care Coordinator 2-Nurse  (Announcement 30861)
Location: Carson City, Nevada

Health Care Coordinator 2 Nurse

The State of Nevada is an equal opportunity employer offering generous benefits for medical, dental, vision care, life and disability insurance; paid leave and holidays; contribution to the secure defined-benefit retirement plan (NV PERS) and additional benefits for long-term employees.

Nevada offers affordable housing choices in high-energy city, peaceful suburban and quaint rural settings; excellent educational options for students in K-12, community colleges and universities; world-class entertainment and cultural events and unparalleled outdoor recreation opportunities.

Click here https://nvapps.state.nv.us/NEATS/Recruiting/ViewAnnouncement.aep?recruitmentId=30861 for more information on this position and to apply.

Please click the following links for information on how to apply for this position, frequently asked questions on applications and information on working for the State of Nevada.