Medicaid Member Enrollment Oversight Officer - State of Iowa : Job Details

Summary:

The Iowa Department of Health and Human Services (HHS), Iowa Medicaid Division, is seeking a Medicaid Member Enrollment Oversight Officer. Medicaid is a state-federal funded program that is administered by Iowa HHS, and is the second largest insurance program in the State of Iowa. Be a part of an organization that is continually working to modernize and innovate solutions to improve the quality of life and health outcomes for the State's Medicaid members.

The Medicaid Member Enrollment Oversight Officer is responsible to coordinate all aspects of Medicaid member enrollment requirements as the Division lead on member enrollment policies and procedures. This position ensures compliance with member enrollment contract provisions, develops and maintains member enrollment operational standards in compliance with federal and state rules and regulations.

Responsibilities:

As the Division lead on member enrollment and beneficiary support, this position is responsible as the member enrollment policy subject matter expert (SME). Develops and implements oversight processes on member enrollment functions. This key postion will serve as the liason with the Medicaid eligiblity policy team and Member Services Unit staff. Work in collaboration with the Medicaid contractors and state teams to identify areas of risks and facilitate solutions for improvements. Evaluate and resolve operational problems associated with member enrollment and beneficiary support. Collaborate in member enrollment modernization activities to improve processes for program effeciencies. Provide guidance to management on program processes ensuring federal and state compliance.

Requirements:

Successful candidates will:

Build tools and reports to monitor and track program compliance.

Analyze a variety of information to identify areas of non-compliance.

Undersand andinterpret federal and stte reuirements nd how those apply to state compliance.

Prioritize work assignemnts to effectively meet deadlines.

Evalluate areas of risk and identify recommended changes.

Communicate efectively to inform and foster productive relationships.

How to Apply:

For help creating a profile or entering your information, please go to the online: Employment Application Guide.

Benefits:

We have a great total compensation package for all our full-time employees, including:

* Iowa Public Employees' Retirement System (IPERS) (Employee contributes 6.29%/State of Iowa contributes 9.44%)

* Retirement Investors Club (RIC) (Employer Sponsored Retirement Plan) (State of Iowa matches up to $75/month)

* Health, Dental and Vision Insurance (See below for more details)

* Vacation Leave (96 hours/year to begin, and increases with years of service)

* Sick Leave (144 hours/year)

* Paid Holidays (9 days/year)

* Flexible Spending Accounts

* Life Insurance ($20,000 paid for by the State of Iowa)

* Long-Term Disability Insurance

For additional information on our amazing benefits, click on this link Benefits at a Glance.

Click here to see how we compare with other employers or offers by using our Total Compensation Calculator.

Director's Statement:

HHS values those with lived experience and encourages adults who were fostered as youth, foster parents, and/or parents who were in the DHS system to apply. Minorities, women, persons with disabilities and veterans are encouraged to apply (Hearing and Speech Impaired - Relay Iowa 1-800-###-#### TDD).

E-Verify Statement:

Our agency uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify.

Applicants must meet at least one of the following minimum requirements to qualify for positions in this job classification:

1)Graduation from an accredited four-year college or university with a degree in any field, and experience equal to five years of full-time work in investigative or closely related work which involved: preparing interpretative or administrative orders, rules, or regulations which have the effect of law; or interpreting and enforcing federal or state laws governing health care administration; or quality assurance review to determine, through internal audit or analysis, the level of compliance with program requirements; or drafting, negotiating, or examining contracts or related documents required for organizational operations.

2) Graduation from an accredited four-year college or university with a degree in any field, and experience equal to five years of full-time, professional-level work involving the interpretation and enforcement of federal and state laws or department policies and procedures or quality assurance review as determined through internal audit or analysis of the level of compliance to program requirements.

3) Graduation from accredited school of law and experience equal to two years of full-time work as described in number one or two or in the practice of law.

4) A total of nine years of education and/or full-time experience (as described in number one, two, or three), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience.

5) Current, continuous experience in the state executive branch that includes experience equal to two years of full-time management/supervisory work in the interpretation and enforcement of federal and state laws or department policies and procedures or quality assurance review.

6) Current, continuous experience in the state executive branch that includes experience equal to eighteen months of full-time work as a Compliance Officer 1.

For additional information, please click on this link to view the job description.