Description of Work/Duties:

Consultant will work with the Department of Human Services, Office of Medical Assistance Programs (Department).

Consultant will:

Be available as a consultant on average 37.5 hours per week.

Possess a documented work history of two or more years of experience performing provider relations/network management and administration within the previous five years.

Possess basic computer skills, including familiarity with Microsoft Office programs.

Work on special projects as assigned to the Bureau including new Department initiatives and implementation of new Federal and State regulations affecting the provider enrollment process.

Responsible for the review and analysis of Medical Assistance Program objectives, regulations, and policies as they relate to enrollment by maintaining a system for evaluation and interpretation, and implementation to ensure compatibility and program compliance.

Research and respond in writing to enrollment interpretations, questions, complaints, or inquiries on enrollment related issues received from providers, legislators, provider associations and legal services organizations. Preparations of responses requires intensive research, a thorough understanding of Medical Assistance Program policy and enrollment procedures, and an understanding of the Department’s Enrollment system. Responses must be reviewed by a supervisor prior to being sent out of the Provider Enrollment Unit as they are frequently prepared for the Secretary, Deputy Secretary, Bureau Director and Division Director.

Serves on interdepartmental workgroups, leads meetings and works as a team member within Provider Enrollment.

Answers Provider Enrollment Service Center calls and assists in the resolution of Question and Answer forms that are generated from Service Center phone calls.

Performs Quality reviews for enrollment staff members to ensure data integrity within the provider enrollment system.

Reviews and enrolls provider enrollment applications as needed.

About Us:

TulaRay partners with clients to create staffing solutions that meet unique organizational needs. Our services are designed to reduce administrative burdens, protect your brand, and improve assignment time-to-fill. We believe that mutually successful client relationships are built on lasting quality and exceptional customer service. We pride ourselves on our uncompromising commitment to high-quality emergency management & healthcare personnel, while ensuring that our clients are taken care of with personalized attention. TulaRay manages total compliance and respectfully supports hundreds of professionals and patient-centered programs.

TulaRay is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation, please let us know by visiting our website at tularay.com