What are the responsibilities and job description for the Program Policy Bureau Chief (HCA/MAD #7778) position at State of New Mexico?
Posting Details
Interviews are anticipated to be conducted within two weeks of closing date.
This job posting may be used to fill multiple vacancies.
The Health Care Authority (HCA) participates in E-Verify and will verify employment eligibility upon hire.
Our Vision
Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.
Our Mission
We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Our Goals
Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
Build the best team in state government by supporting employees continuous growth and wellness.
Why does the job exist?
The Program Policy Bureau Chief will:
Provide direction and leadership related to most Medicaid covered health care services and benefits, including physical health, behavioral health, and dental services;
Oversee analysis of federal rules, promulgation of the New Mexico Administrative Code (NMAC) and fair hearings;
Provide support and oversight of provider reimbursement rates and payment methodologies ensuring the Medicaid claims processing system correctly enforces Medicaid reimbursement policy.
How does it get done?
The Program Policy Bureau Chief is responsible for:
Ensuring new Medicaid benefits and services are operationalized within state and federal timelines;
Directing and overseeing Medicaid payment parameters, rates setting, and payment methodologies;
Directing and overseeing policy analysis of states and federal rules;
Ensuring NMAC promulgations are completed in alignment with State Records Center and Archives (SRCA) requirements;
Ensuring fair hearings are processed in accordance with applicable regulations and timelines;
Providing Medicaid guidance and recommendations to the Medicaid Director's Office related to benefit package design, covered services, and payment methodologies;
Ensuring integrity and responsiveness for Medicaid program related to covered health care services and benefits, physical health, behavioral health, and dental services;
Coordinating with other bureaus and agencies assuring that coverage and payment align with state and federal laws and directives.
Who are the customers?
Internal and external stakeholders across Health Care Authority (HCA) and Medical Assistance Division (MAD);
Medicaid recipients and providers;
State and Federal agencies.
Ideal Candidate
Internal and external stakeholders across Health Care Authority (HCA) and Medical Assistance Division (MAD);
Medicaid recipients and providers;
State and Federal agencies.
Minimum Qualification
Associate degree in Business Administration, Healthcare Administration, Statistics, Finance, or a related field and seven (7) years of experience with a public assistance program, medical, healthcare, educational, or state facility working with policies and procedures, conducting analysis/research, providing or requesting information from the general public, working with communities, working on health or social service related matters, social work/case management, behavioral health, and/or health care. Any combination of education from an accredited college or university in a related field and/or direct experience in this occupation totaling nine (9) years may substitute for the required education and experience.
Employment Requirements
Must possess and maintain a valid driver's license.
Must obtain a Defensive driving certification.
Working Conditions
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT), extensive personal computer and phone usage with extended periods of sitting.
Supplemental Information
Do you know what Total Compensation is? Click here
Agency Contact Information: Jolene Jaffa, (505) 690-9920. Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is not covered by a collective bargaining agreement.
Interviews are anticipated to be conducted within two weeks of closing date.
This job posting may be used to fill multiple vacancies.
The Health Care Authority (HCA) participates in E-Verify and will verify employment eligibility upon hire.
Our Vision
Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.
Our Mission
We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Our Goals
Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
Build the best team in state government by supporting employees continuous growth and wellness.
Why does the job exist?
The Program Policy Bureau Chief will:
Provide direction and leadership related to most Medicaid covered health care services and benefits, including physical health, behavioral health, and dental services;
Oversee analysis of federal rules, promulgation of the New Mexico Administrative Code (NMAC) and fair hearings;
Provide support and oversight of provider reimbursement rates and payment methodologies ensuring the Medicaid claims processing system correctly enforces Medicaid reimbursement policy.
How does it get done?
The Program Policy Bureau Chief is responsible for:
Ensuring new Medicaid benefits and services are operationalized within state and federal timelines;
Directing and overseeing Medicaid payment parameters, rates setting, and payment methodologies;
Directing and overseeing policy analysis of states and federal rules;
Ensuring NMAC promulgations are completed in alignment with State Records Center and Archives (SRCA) requirements;
Ensuring fair hearings are processed in accordance with applicable regulations and timelines;
Providing Medicaid guidance and recommendations to the Medicaid Director's Office related to benefit package design, covered services, and payment methodologies;
Ensuring integrity and responsiveness for Medicaid program related to covered health care services and benefits, physical health, behavioral health, and dental services;
Coordinating with other bureaus and agencies assuring that coverage and payment align with state and federal laws and directives.
Who are the customers?
Internal and external stakeholders across Health Care Authority (HCA) and Medical Assistance Division (MAD);
Medicaid recipients and providers;
State and Federal agencies.
Ideal Candidate
Internal and external stakeholders across Health Care Authority (HCA) and Medical Assistance Division (MAD);
Medicaid recipients and providers;
State and Federal agencies.
Minimum Qualification
Associate degree in Business Administration, Healthcare Administration, Statistics, Finance, or a related field and seven (7) years of experience with a public assistance program, medical, healthcare, educational, or state facility working with policies and procedures, conducting analysis/research, providing or requesting information from the general public, working with communities, working on health or social service related matters, social work/case management, behavioral health, and/or health care. Any combination of education from an accredited college or university in a related field and/or direct experience in this occupation totaling nine (9) years may substitute for the required education and experience.
Employment Requirements
Must possess and maintain a valid driver's license.
Must obtain a Defensive driving certification.
Working Conditions
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT), extensive personal computer and phone usage with extended periods of sitting.
Supplemental Information
Do you know what Total Compensation is? Click here
Agency Contact Information: Jolene Jaffa, (505) 690-9920. Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is not covered by a collective bargaining agreement.
Benefits:
Health Insurance, Vacation & Paid Time Off, Retirement PlanSalary : $46 - $74