Program Processing Specialist - Medicaid BLTC
The Department of Health and Welfare
DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS
Applications will be accepted through 4:59 PM MST on the posting end date.
The Idaho Department of Health & Welfare, Division of Medicaid, Bureau of Long Term Care (BLTC) has an exciting opportunity for a forward-thinking, self-directed, innovative team member to join our team as a Program Processing Specialist.
This position will process completed level of care assessments for Personal Care Services and Aged and Disabled Waiver participants conducted by Nurse Reviewers in the field, generate participant Support Plans from the Nurse Reviewer assessment, complete eligibility workflow to internal partners (Self-Reliance) and issue annual service authorizations. This position will also be required to perform support functions as needed to support BLTC business needs, including scheduling and coordinating with Nurse Reviewers to complete participant assessments, attending monthly BLTC meetings, biweekly staff meetings and providing input on bureau processes to ensure continual quality improvement. This position will directly support and work closely with the bureau’s nursing staff, program staff, participants and Idaho Medicaid providers. We are seeking applicants with experience navigating complex individual case scenarios, working in varied computer database systems and working with vulnerable populations. The ability to deliver excellent customer service and work in a fast-paced, evolving, dynamic work environment is required.
BENEFITS:
BEST RETIREMENT AVAILABLE IN THE NATION
We have one of the Nation's best state retirement systems (PERSI) that offers a lifetime benefit.
OTHER EXCELLENT BENEFITS
- 11 paid holidays
- Generous vacation and sick leave accrual beginning as soon as you start
- Paid parental leave
- Medical, dental, vision insurance - incredible rates!(full-time/30+ hours per week)
- PERSI Choice 401(k)
- Deferred compensation plan
- Life insurance
- Short and long-term disability insurance
- Student Loan Forgiveness
- Wellness programs
- Employee Assistance Program (EAP)
- Flexible Spending Accounts (FSA)
- Wide variety of training opportunities
- Some positions offer flexible hours and/or telecommuting
EXAMPLE OF DUTIES:
- Generate participant Support Plans and complete follow-up work required after Nurse Reviewers complete in-home assessments.
- Complete eligibility workflows, ensuring information is accurate and processed timely.
- Review worklist activity database reports, assist Nurse Reviewers with processing and other support functions and needs.
- Create system authorizations for appropriate services based on clinical assessment and participant selection of service providers.
- Provide support and assistance to Nurse Reviewers when needed, including scheduling and coordinating assessments with Nurse Reviewers, and attending various staff meetings.
- Collects and analyzes program case management data to identify trends and recommend program changes.
- Possess a high attention to detail, exceptional documentation and writing abilities, and organizational skills, including proficiency with a minimum intermediate level experience in Microsoft Word, Excel and other computer programs.
MINIMUM AND SPECIALTY MINIMUM QUALIFICATIONS:
You must possess all the minimum and specialty minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum and specialty 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.
- Some knowledge of management practices. Typically gained by completion of a college-level course OR 20 hours of management training that included all the essential elements of management (Planning, Organizing, Leading, Controlling) OR three months of experience performing all management elements.
- Some knowledge of program or project planning and implementation. Typically gained by at least one year of experience on a committee or with a group that involved program planning and implementation.
- Experience developing and evaluating policies and procedures. Typically gained by at least six months of experience writing or assisting in reviewing/auditing and developing policies, procedures, field memorandums. directives or post orders.
SPECIALTY MINIMUM QUALIFICATIONS:
- Experience developing and evaluating training and presentation materials. Typically gained by at least six months of experience writing or assisting in reviewing/auditing and developing policies, procedures, field memorandums. directives or post orders.
- Experience reviewing documents for accuracy, completeness, and compliance. Typically gained through at least one years' experience in a work setting reviewing documents for accuracy of information contained in the document, completeness of the information contained in the document, and compliance with rules, regulations, policies, and laws.
- Experience using database management systems for tracking and reporting. Typically gained through approximately one year of experience creating, formatting, editing, sorting, filtering, printing and storing data in customized tables using a database; customizing tables; importing and exporting data to tables within the database; and creating forms and reports.
- Good knowledge of state and federal laws and regulations regarding the confidentiality and safeguarding of citizen and governmental information. Typically gained by at least one year of experience performing these duties.
***PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 4:59 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.