This position is open to Alaskan Residents only.
What You Will Be Doing:
As the Medicaid Program Specialist 3 within the Division of Health Care Services, Quality Assurance Unit, you will develop and implement the Special Member-Based Program Initiatives, Care Management Program (CMP), and Alaska Medicaid Coordinated Care Initiative (AMCCI). The work performed in this position is critical in reducing misuse of the Alaska Medicaid program, encouraging continuity of care, and promoting communication between the recipient's primary care provider and pharmacy. We are seeking applicants who demonstrate a high level of initiative, have excellent interpersonal skills, and will thrive in the ever-changing healthcare landscape.
This position will review and develop metrics and profiles for CMP placement consideration,
monitor member care and medical claims patterns, and regularly interface with physicians,
pharmacists, and other healthcare professionals in promoting coordination of services between Alaska Medicaid members. Additional responsibilities include working with the contractor(s) to identify, approve, and discharge appropriate recipients, serving as a subject matter expert regarding the CMP and AMCCI programs, and monitoring and enforcing vendor contract(s) compliance.
Mission and Values/Culture:
The Division of Healthcare's mission is to provide to all eligible Alaskans access and oversight to the full range of appropriate Medicaid services.
The department's vision is to innovate health plans that improve quality of health care for all Alaskans, attract excellent providers, and be known for outstanding customer service.
The selected candidate's contribution ensures that the division's goals and vision are being met by maintaining the integrity of the system and conforming to federal and state rules and regulations.
Benefits of Joining Our Team:
We are a dynamic, diverse, high-performing team that focuses on excellent customer service and accuracy. The incumbent will work with a team of highly dedicated, hardworking individuals committed to ensuring the health, well-being, and safety of our vulnerable population. The work environment is positive, professional, constructive, and detail-oriented. You will gain valuable professional experience in the fields of Medicaid compliance and quality assurance.
The Working Environment You Can Expect:
Our newly renovated office space is located in the heart of Anchorage, close to many amenities like shopping, parks, and dining. The workspace is clean and bright and features mountain views from the office suite. Employees are on a telework rotation and receive an assigned parking space for convenience.
Who We Are Looking For:
The ideal candidate will possess some or all of the following position-specific competencies:
Compliance: Knowledge of procedures for assessing, evaluating, and monitoring programs or projects for compliance with State and federal laws, regulations, and guidance.
Self-Management: Sets well-defined and realistic personal goals; displays a high level of initiative, effort, and commitment towards completing assignments promptly; works with minimal supervision; is motivated to achieve; demonstrates responsible behavior.
Reading: Understands and interprets written material, including technical material, rules, regulations, instructions, reports, charts, graphs, or tables; applies what is learned from written material to specific situations.
Computer Knowledge and Skill: Using computer software such as Microsoft Office, including Outlook, Word, Adobe DC Pro, Microsoft Teams, Access database, Excel, SharePoint, etc.
A cover letter is NOT required for this position. Your complete application, including supplemental questions, will be used to determine which applicants will advance to the interview phase of the recruitment and selection process.
To view the general description and example of duties for this job class, please go to the following link and search for Medicaid Program Specialist 3: https://www.governmentjobs.com/careers/Alaska/classspecs