Medicaid Program Specialist 2 – (SURS Administrative Coordinator (PCN 064062)

Job Description

Welcome to the Department of Health! We’d be delighted to have you join our team. If you envision yourself in this role and are ready to start an exciting career with us, apply today!

This position is open to Alaskan Residents only. Please check out the residency definition to determine if you qualify.

What you will be doing: In this role, the SURS Administrative Coordinator provides a variety of professional-level administrative functions to support the Care Management Program (CMP) and Surveillance and Utilization Review (SURS) teams in the Quality Assurance Unit. You will be responsible for a variety of assignments that are analytical, coordinative, implementing, and assessing, and require knowledge and experience with Medicaid/Medical Assistance programs and services. Additionally, the position provides a variety of professional services and assignments such as coordinating, planning, implementing, and assessing Medicaid activities, monitoring no-show activity, providing policy and procedure analysis, interpretation, or input, drafting policy and procedure or regulations, overseeing numerous fiscal agent activities, reviewing authorization and claims processing activities, and providing other professional services to administer and maintain Medicaid/Medical Assistance programs, to include conducting member reviews and generating notification materials for program placement in line with the Department policies and State and Federal regulations. This position may respond to and provide research for a variety of tasks such as Fair hearing research, analyzing claim data, ensuring compliance with program requirements, and assisting with CMP and SURS processes.

Our organization, mission, and culture: The Quality Assurance unit is instrumental in ensuring that the integrity of the Medicaid Program is protected. The mission of the Division is to provide all eligible Alaskans with access to quality Medicaid services. The vision of the Division is to improve quality of health care for all Alaskans, attract excellent providers, and provide outstanding customer service. The contributions of the selected candidate ensure that the goals and vision of the Division are met by ensuring programs conform to federal and state rules and regulations.

The benefits of joining our team: The Quality Assurance Unit (QA) is a multi-faceted environment where we strive to create a balance between hard work, compassion, collaboration, and fun. We are a dynamic, diverse, high-performing team of highly dedicated, hardworking individuals committed to ensuring our vulnerable population’s health, well-being, and safety. All team members’ input is valued, and we are always looking to provide growth and learning opportunities for our team members. The QA team operates on a hybrid work schedule with a mix of in-office and work from home days.

The working environment you can expect: Our office is located midtown in the Calais Building, at 3201 C. Street. Ste. 202. The workspace is clean, bright, and features mountain views from the office suite. This position also features an assigned parking space for convenience.

Who we are looking for: We are interested in candidates who possess some or all of the following position-specific competencies:• 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.

• Writing: Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a brief, clear, and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.
• Problem Solving: Identifies problems; determines accuracy and relevance of information; uses sound judgment to generate and evaluate alternatives, and to make recommendations.

The ideal candidate will possess some or all of the following position-specific competencies in addition to the minimum qualifications listed below:

Special Notice:•Basic knowledge of Medicaid/Medical Assistance terminology, programs, policies and procedures, and rules and regulations at the state and federal levels is preferred. •Sufficient knowledge of Medicaid and/or other health care services, health care claiming and delivery systems is preferred.

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 2]: https://www.governmentjobs.com/careers/Alaska/classspecs

Minimum Qualifications

Competency-Based Minimum Qualifications Instructions This job class uses competency-based minimum qualifications. Please ensure your application (through work history, volunteer experience (duties summary), training, education, licenses, certifications, etc.) supports how you have gained the knowledge, skills, abilities, and behaviors (competencies) and that you possess the minimum required competencies for the job class.

Competency Description The competency description(s) listed below have been designed to promote a common understanding of the essential elements of the job class. They highlight the more general and customary knowledge, skills, abilities (KSAs), tasks, and behaviors used to describe the competency. They typically list expectations rather than specific tasks and are to be used only as parameters and guidelines. A competency’s description is not intended to exclusively define every KSA, task, and behavior needed to successfully meet the competency, but rather to provide the manager/agency with a broad reference of options as to how an applicant can meet the job expectation.

Please ensure your application (through work history, training, education, licenses, certifications, etc.) supports/demonstrates that you possess the minimum required competencies for the job class.

Any combination of education and/or experience that provides the applicant with competencies in:

Analytical Thinking/Problem Solving: Uses a logical, systematic, and sequential approach to address problems or opportunities or manage a situation by drawing on one’s knowledge and experience base and calling on other references and resources, as necessary. Oral Communication: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately. Written Communication: Writes in a clear, concise, organized, and convincing manner for the intended audience. Equivalent to those typically gained by: Progressively responsible experience such as supporting the administration of a Medicaid or Medicare program, health insurance service, health insurance management information system, health insurance finance or accounting program, Supplemental Security Income benefits or vocational rehabilitation program; auditing or monitoring medical or public assistance programs for fraud or quality assurance; processing medical claims using medical coding and medical billing knowledge; designing, developing, testing for quality assurance, and implementing an information system and/or training or education which includes such course work as business administration, computer sciences, economics, healthcare, legal studies, medical billing or coding, public health, public assistance, psychology.

“Competencies” means a combination of interrelated knowledge, skills, abilities, and behaviors that enable a person to act effectively in a job or situation. “Progressively responsible” means indicating growth and/or advancement in complexity, difficulty, or level of responsibility. “Training” and “education” in this guidance are synonyms for the process of acquiring knowledge and skills through instruction. It includes instruction through formal and informal methods (such as classroom, on-line, self-study, and on-the-job), from accredited and unaccredited sources, and long-duration (such as a post-secondary degree) and short-duration (such as a seminar) programs.

“Typically gained by” means the prevalent, usual method of gaining the competencies expected for entry into the job.

Additional Required Information

At the time of the interview, please provide the following:

• Copies of three (3) professional references with current contact information, including your current or past supervisor. *Professional is defined as a supervisor or an individual who has direct knowledge of your work performance.

• Copies of your three (3) most recent performance appraisals. If unavailable, supervisory letters of reference may be substituted.

Please read the information below carefully. This applies to your application submission. SUPPLEMENTAL QUESTIONS For your application to be evaluated, you must answer the Supplemental Questions. The State of Alaska uses four proficiency levels to measure and describe an applicant's competence in applying specific behaviors, knowledge, skills, and abilities to accomplish a specific task. The four proficiency levels are Mastery, Fluency, Literacy, and Discovery. You must rate your proficiency level for each competency listed in the supplemental questions.

EDUCATION To verify education is being used to meet and/or support the required minimum qualifications/competencies, you must fill in the Education section of the application If you have not obtained a degree, please indicate the number of units completed Copies of transcripts are required to verify educational credentials used to meet or support the minimum qualifications/competencies for a position and are required with each application (Unofficial is okay; please ensure the institution/URL name is listed on the transcripts) Transcripts can be attached at the time of application or provided at the time of interview; if not, transcripts will be required before employment.

SPECIAL INSTRUCTIONS FOR FOREIGN EDUCATION If education is completed in a foreign college or university, it may be used to meet the above requirements, if applicable. If utilizing this education, you must show that the education credentials have been submitted to a private organization that specializes in the interpretation of foreign educational credentials and that such education has been deemed to be at least equivalent to that gained in conventional U.S. education programs or an accredited U.S. state university reports the other institution as one whose transcript is given full value, or full value is given in subject areas applicable to the curricula at the state university. It is your responsibility to provide such evidence when applying. The omission of the required documentation listed will result in an incomplete application, and you will not receive further consideration.

WORK EXPERIENCE When using work experience not documented in your application, please provide the employer's name, job title, employment dates, and whether you worked full-time or part-time. Applications will be reviewed to determine if the responses are supported and if minimum qualifications are met. Work experience needed to meet the minimum qualifications must be documented in the application. If the application does not support minimum qualifications, the applicant may not advance to the interview and selection phase of the recruitment. A resume will not be used to determine that minimum qualifications have been met for the position you are applying for.

If you have currently or previously been appointed to a flexibly staffed position, please ensure your work experience within a flexibly staffed position indicates the actual dates employed at each level. Ensure your time and any subsequent flex promotion(s) are documented as a separate position. This is required as minimum qualifications require experience at a particular level in which the lower level may not be considered. If this information is not accurately reflected in your application, this may cause the processing of your application for consideration to be delayed.

NOTE: Attaching a resume or curriculum vitae is not an alternative to filling out the application. Noting "see resume or CV" or any similar response on any portion of your application may lead to a determination that your application is incomplete and removal from consideration for this job posting.

MULTIPLE VACANCIES This recruitment may be used for more than one (1) vacancy. The applicant pool acquired during this recruitment may be used for future vacancies for up to ninety (90) days after this recruitment closes. Interested applicants are encouraged to apply to each recruitment notice to ensure consideration for all vacancies.

APPLICATION NOTICE You can ONLY apply for this position through the Workplace Alaska website or via a hard copy application. If you accessed this recruitment bulletin through a job search portal such as AlaskaJobs or another database, you MUST use a Workplace Alaska online or hard-copy application to apply successfully. Instructions on how to apply with Workplace Alaska may be found on the Workplace Alaska "How to Apply" webpage, found here: http://doa.alaska.gov/dop/workplace/help/.

NOTICE Questions regarding the application process can be directed to the Workplace Alaska hotline at 800-587-0430 (toll-free) or (907) 465- 4095. If you choose to be contacted by email, please ensure that your email address is correct on your application and that your spam filter will permit emails from the 'governmentjobs.com' domain. For information on allowing emails from the 'governmentjobs.com' domain, visit the Lost Password Help page at: https://www.governmentjobs.com/OnlineApplication/User/ResetPassword.

EEO STATEMENT The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA). Individuals with disabilities who require accommodations, auxiliary aids, or services, or alternative communication formats, please call 1-800-587-4095 in Juneau or TTY: Alaska Relay 711 or 1-800-770-8973 or correspond with the Division of Personnel & Labor Relations at P.O. Box 110201, Juneau, AK 99811-0201. The State of Alaska is an equal-opportunity employer.

WORKPLACE ALASKA APPLICATION QUESTIONS & ASSISTANCE Questions regarding application submission or system operation errors should be directed to the Workplace Alaska hotline at 1-800-587-0430 (toll-free) or (907) 465-4095 if you are in the Juneau area. Requests for information may also be emailed to [email protected].

For assistance with applying for a password, please visit https://www.governmentjobs.com/OnlineApplication/User/ResetPassword.

Contact Information

For specific information in reference to the position, feel free to contact the hiring manager at:

Name/Title: Elizabeth LaRue/SURS Manager Phone: 907-317-7402 Email: [email protected]