This position is open to Alaska Residents only.
Please check our residency definition to determine if you qualify.
The recruitment period for this job posting has been extended.
The Division of Health Care Services is seeking two new team members in Anchorage Alaska!
What you will be doing:
These positions serve within the Systems and Analysis unit in direct support of the Medicaid Management Information System (MMIS). The incumbents are responsible for quality assurance, contract management tasks, DDI (design, development and implementation) tasks, and monitoring changes in health industry standards, federal and state requirements as they relate to Medicaid and the MMIS.
Position one serves as the lead claims administrator and acts as the subject matter expert (SME) in areas such as benefit plan configurations, claims processing outcomes, third party cost avoidance, service authorization, and edits/exception codes maintenance.
Position two serves as the decision support system (DSS) administrator and acts as the SME in areas such as data extracts, data loads, data translations, claims pricing and payment, management and administrative reports, and federal reports.
Our organization, mission and culture:
The mission of the Division is to provide all eligible Alaskans 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 visions of the Division are being met by ensuring the integrity of the system is maintained and conforms to the federal and state rules and regulations.
The benefits of joining our team:
We are a dynamic, innovative, and fast-paced team. All team members' input is valued, and we are always looking to provide growth and learning opportunities for our team members.
The working environment you can expect:
These positions are located at 4601 Business Park Blvd, Bldg. K in Anchorage, central for shopping and commuting.
Current schedule is two days in office for team interaction and three days teleworking from your home. Free parking is available at the office.
Who we are looking for:
Experience in conducting detailed, comprehensive and technically-oriented reviews of system testing documents, audit trails, system outputs, related reports and documents.
Experience and skills that demonstrate an ability to independently analyze and apply comprehensive business rules, regulations, policies, and health payer industry standards as they apply to claims system processing.
Ability to successfully work with multiple priorities (multi-tasking) while maintaining a very high degree of accuracy on detail-oriented tasks.
Ability to work independently and interdependently to analyze design concepts and system modifications for thoroughness, accuracy, and compliance with federal and state standards.
Ability to take initiative and to find new methods to improve work tasks with limited supervision.
To view the general description and example of duties for a Medicaid Program Specialist 3, please go to the following link: https://www.governmentjobs.com/careers/Alaska/classspecs Minimum Qualifications
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.
Technical Expertise: Effectively applies technical knowledge to solve a range of problems; develops technical solutions to new or highly complex problems that cannot be solved using existing methods or approaches; is sought out as an expert to provide advice or solutions in the technical area.
Written Communication: Writes in a clear, concise, organized, and convincing manner for the intended audience.
equivalent to those typically gained by:
Progressively responsible professional 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.
"Professional experience" means work that is creative, analytical, evaluative, and interpretive; requires a range and depth of specialized knowledge of the profession's principles, concepts, theories, and practices; and is performed with the power or right to decide or act according to one's own judgment.
"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 time of interview applicant(s) are requested to submit:
A copy of academic transcripts (unofficial are okay, please ensure that the institution name/URL is listed on the transcripts) to verify that you meet the minimum qualifications.
Your two (2) most recent performance evaluations or letters of recommendation
List of three (3) references with current phone number and email address, one of whom should be a supervisor
Please read the below information carefully. This applies to your application submission.
For your application to be evaluated you must answer the Supplemental Questions. Be specific in your answers and tell us how you acquired the relevant experience.
Please use complete sentences and proof-read your submissions when answering the supplemental questions. Your responses will be considered a writing sample and will be used to determine which applicants will advance to the interview phase of the recruitment process.
A cover letter is required. The cover letter must describe your knowledge, skills, abilities, as they pertain to the job description listed above.
Please attach the cover letter as a separate document to your application before applying online. If unable to attach to your application, email or fax the cover letter to the contact number provided in the job posting prior to the closing date of this recruitment. Your cover letter will be used to determine which applicants will advance to the interview phase of the recruitment and selection process. Omission of any required documentation will result in an incomplete application and you will not receive further consideration.
To verify education being used to meet the required minimum qualifications, 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 being used to meet the minimum qualifications for a position and are required with each application. (Unofficial are okay, please ensure that the institution/URL name is listed on the transcripts). Transcripts can be attached at the time of application, provided at the time of interview or if not provided, transcripts will be required prior to appointment.
SPECIAL INSTRUCTIONS FOR FOREIGN EDUCATION
Education completed in foreign colleges or universities 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 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. Omission of required documentation listed will result in an incomplete application and you will not receive further consideration.
When using work experience not already documented in your application, please provide the employer name, your job title, dates of employment, and whether full-or part-time. Applications will be reviewed to determine if the responses are supported and minimum qualifications are clearly 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 in which you are applying.
If you are 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 there are minimum qualifications that 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 in its entirety. Noting "see resume or CV" or any similar response on any portion of your application may lead to a determination your application is incomplete and removal from consideration for this job posting.
The State of Alaska does not provide VISA Employer sponsorships.
This position is open to Alaska Residents only. Please check our residency definition to determine if you qualify.
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.
You can ONLY apply for this position through the Workplace Alaska website or via hardcopy application. If you accessed this recruitment bulletin through a job search portal such as ALEXsys or any other database, you MUST use a Workplace Alaska online or hardcopy application to successfully apply. 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/
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 your email address is correct on your application and that the spam filter will permit email from the 'govermentjobs.com' domains. For information on allowing emails from the 'governmentjobs.com' domains, visit the Lost Password Help page located at https://www.governmentjobs.com/OnlineApplication/User/ResetPassword.
The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA). Individuals with disabilities, who require accommodation, auxiliary aides 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 located in the Juneau area. Requests for information may also be emailed to firstname.lastname@example.org.
For applicant password assistance please visit:https://www.governmentjobs.com/OnlineApplication/User/ResetPassword
For specific information in reference to the position please contact the hiring manager at:
Name: Lisa Myers, Administrative Officer 2
Phone: (907) 465-5827
Fax: (907) 561-1684
State Of Alaska