Program Specialist DHW - MED

DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS

*THIS ANNOUNCEMENT WILL BE OPEN UNTIL FILLED. APPLICANTS ARE ENCOURAGED TO APPLY AS SOON AS POSSIBLE TO BE CONSIDERED.*

The Idaho Department of Health and Welfare, Division of Medicaid, is currently seeking a Program Specialist - DHW with experience in Medicaid or other health care industry work including government or private health care. This position is located in the Bureau of Financial Operations in Boise’s Central Office . Candidates may request to telework part time upon successful completion of probation, but the option is only available in the state of Idaho. No out-of-state telework requests will be approved.

As a Program Specialist - DHW, you will provide reimbursement maintenance and project support for topics such as Long Term Care (LTC), Hospice, and Home and Community Based Services (HCBS) rate development. This position works directly with internal and external stakeholders via email, in-person and virtual meetings, and phone calls. Internal stakeholders include but are not limited to Division and Department program support staff as well as other state agency staff. External stakeholders include but are not limited to provider groups, provider associations, third-party contractors, other state Medicaid agency staff, and the Centers for Medicare and Medicaid Services staff.

We are seeking highly-organized candidates with experience researching and analyzing documents to ensure compliance with federal and state laws, regulations, and accounting principles; communication and interpersonal skills; project management skills; problem solving skills; critical thinking skills and team learning competencies.

This position may be eligible for limited telework after successful completion of probation and necessary training. Approval to telecommute is not guaranteed and subject to termination at any time.

BENEFITS:

BEST RETIREMENT AVAILABLE IN THE NATION

The State of Idaho offers a robust total compensation and benefits package, including but not limited to:

• We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit at retirement.
• 11 paid holidays
• Paid sick and vacation that begins accruing on your first day of employment; can be used immediately after accruing (no waiting time)
• Paid parental leave
• Medical, vision, and dental insurance benefits that become effective first of the month following your hire date. All contributions can be pre-tax (full-time/30 hours per week)
• 2 voluntary supplemental retirement plans including both pre-tax and Roth options
• Deferred compensation plan
• Life insurance for self, spouse, and children
• Short and long-term disability insurance
• Flexible Spending Accounts (FSA)
• Wide variety of training opportunities
• Some positions offer flexible hours and/or telecommuting
• Additional perks and discounts available through medical provider
• Public Service Loan Forgiveness (PSLF) Eligibility
• Employee assistance program

Additional information related to benefits and/or State programs can be found here: https://dhr.idaho.gov/StateEmployees/Benefits.html.*

EXAMPLE OF DUTIES:

• Review, understand, and apply federal and state rules, regulations, guidelines, and trends and make recommendations for policy changes related to healthcare billing and coding, Medicaid reimbursement activities, value care and managed care.
• Collaborate with policy and management to draft changes to rule, state plan, fee schedule, waiver application, or to design, modify, implement policy and reimbursement strategies and projects.
• Reconcile, audit, investigate and report on expenditures, budgets, provider reimbursement, and other financial data with internal and federal systems for completeness and compliance with federal and state laws and agreements.
• Communicate and problem-solve to foster professional interpersonal relationships with other intergovernmental financial professionals, program budgeting, and project managers within the department. This will include assisting Medicaid systems and other internal staff, providers and stakeholders with payment and reimbursement questions or updates at a detailed level.
• Support the development and maintenance of financial policies and procedures, contract monitoring, and procurement activities.
• Assist with routine cost and analysis functions relating to value care, managed care, provider payments, and Medicaid reimbursement activities across various provider types.
• Complete other duties, tasks, or assignments as assigned by management.

MINIMUM QUALIFICATIONS:

You must possess all the minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum qualifications for this position. Failure to do this may disqualify you from being considered for this position. It is highly recommended to attach a one-page cover letter to your application to demonstrate how you meet the requirements below.

• Experience developing, recommending and evaluating operating procedures and recommending changes. Typically gained by approximately one year of experience where this was a primary responsibility of the job. This experience may include participation in a regional or statewide quality assurance team, business change or project team or a similar assignment.
• Experience developing technical written materials such as policies, technical manuals or rules/regulations. Typically gained by at least one year experience working in a business setting developing training materials, reports, policy and/or procedure manuals, written interpretations of law, rules, or policies, or any related background which would be considered similar.
• Experience providing technical program assistance to staff. Typically gained by at least one year of experience providing technical assistance to staff in a business setting which could include formal and informal assignments to assist, mentor or train new staff.

Below is preferred experience. It is not required for the position but applicants with this experience may receive consideration over other applicants.

• Knowledge of Private or Public Healthcare. Typically gained by at least one (1) year of experience in a public or private health care setting, managed care setting, value care setting or insurance billing clearing house where use of medical codes was a function of the job.
• Experience in business operations working with financial data, setting reimbursement rates, or budget oversight. Typically gained by at least one (1) year of experience working with large computer systems to process financial data or rate setting.

Learn About a Career with DHW

***PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 11:59 pm on the closing date. When applying, use CHROME as your browser to avoid complications.

If you have questions, please contact us at:

Email is the quickest way to get an answer to your questions.

(answered Monday through Friday during business hours MST)

EMAIL: dhwjobs@dhw.idaho.gov PHONE: (208) 334-0681

EEO/ADA/Veteran:

The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.

The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email ada.coordinator@dhr.idaho.gov.

Preference may be given to veterans who qualify under state and federal laws and regulations.