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State Programs Implementation Specialist at Independent Health Assoc., Inc. in Williamsville, New York

Posted in General Business 30+ days ago.

Type: Full-Time





Job Description:

Overview

The State Programs Implementation Specialist holds accountability for providing support pertaining to the coordination, communication and execution of projects supporting the department strategy roadmap, regulatory Managed Care carve-ins, State population health initiatives, regulatory reporting, audit support, and internal process development assistance and oversight....  The State Program Implementation Specialist will work with the State Products Implementation Managers and various cross-functional teams to ensure project deliverables are achieved as well as provide on-going regulatory support upon completion of implementation.... 

The State Program Implementation Specialist will provide program/project planning, audit, and ongoing regulatory reporting assistance, demonstrating resourceful and collaborative expertise that favorably impacts the results of project initiatives including but not limited to monitoring/evaluation of program/project effectiveness.

Qualifications


  • High School Diploma or GED required. Associate.........s degree preferred.

  • Three (3) years of experience working with a government agency/agencies including but not limited to Department of Health (DOH), Office of Mental Health (OMH), Office of Health Insurance Programs (OHIP), and/or Office of Medicaid Inspector General (OMIG).

  • Demonstrated ability to lead and/or assist with regulatory, business and technical based initiatives to a successful outcome.

  • Experience with Business Process Management design, implementation and performance management.

  • Experience in project management including the definition of project plans and the supervision of project associates for one or more projects.

  • Demonstrated and proven understanding of regulatory requirements as they relate to Medicaid Managed Care Operations

  • Skill in organizing resources and establishing priorities.

  • Strong interpersonal and communication skills and the ability to work effectively with a wide range of associates across multiple business areas.

  • Excellent interpersonal, written and verbal communication skills required.

  • Ability to effectively communicate with internal and external teams and agencies

  • Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Key Accountabilities

A. Responsible for supporting the development, and monitoring of an overall program work plan as applicable
B. Responsible for coordinating project deliverables among all internal departments, ensuring codependent milestones and tasks are appropriately managed.
C. Identify process improvement/redesign opportunities; document and redesign business processes as appropriate as well as facilitate process change.
D. Responsible for working with cross-functional business owners, stakeholders, and subject matter experts to develop and assist with development of outcome measures for projects and programs.
E. Assist with DOH audit management, serving as both a Plan to agency liaison and internal regulatory expert.
F. Management and completion of DOH regulatory reporting as maintained within the NYS Medicaid Managed Care Model Contract.
G. Regulate internal system configuration updates for State Programs in support of general coverage implementations, updates, and restrictions.
H. Continuously provide operational support through resolution of daily eligibility, claims, clinical, and coverage inquiries as escalated by operational departments such as Claims, Servicing, Health Care Services, and Network Contract Management with use of extensive regulatory competence and decision making.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant.........s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via their Career Worklet.