Introduction
Are you a motivated analytical minded worker passionate about operationalizing medical programs and implementing new systems to improve healthcare outcomes for members? If this sounds like you, the State of Connecticut, Department of Social Services (DSS), invites you to check out this exciting opportunity!
At DSS, we are actively seeking three independent professionals to become a Health Program Associate. All three positions are located at 55 Farmington Avenue, Hartford, CT 06105 and are full-time, 40 hours per week; Monday- Friday (note: these positions are eligible for partial telework due to the COVID-19 pandemic).
Division of Health Services (DHS):
One position is located in the Division of Health Services. This division is responsible for administering the day-to-day operations for the Connecticut Medicaid program and the Children’s Health Insurance Plan (CHIP). The Medical Operations Unit resides within DHS and is responsible for operationalizing medical program requirements, enrolling providers, paying and reporting expenditures. Duties and responsibilities of the positions include but are not limited to:
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Liaison with stakeholders within and outside of the Agency to define business requirements, workflows, data, and reporting requirements
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Understanding and managing coding and rule configuration in the Medicaid Management Information System to ensure claims for services are processed and paid appropriately.
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Interpret complex Medical Assistance program policies, coverage rules, provider reimbursement rules and system edits and audits to ensure claims are processed in compliance with State and Federal regulations.
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Liaison between business units, administrative service organizations and the claims processing vendor to document new initiative program details and ensure all MMIS system requirements are captured and implemented appropriately.
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Medical Operations lead for Federal and State Audits.
Division of Health Services and the CT Medicaid Enterprise Technology System (CT METS):
One position is matrixed or co-located between two divisions, the Division of Health Services and the CT Medicaid Enterprise Technology System CT METS. This position will have work assigned and managed from both units to support the requirements for the Medicaid Enterprise Technology System Program. Duties and responsibilities of the positions include but are not limited to:
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Engage in the planning, organization, and implementation of specific Medicaid. Enterprise System modules to support Connecticut Medicaid programs, policies, and systems.
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Support CT METS when subject matter expertise in MMIS is needed to support. deliverable reviews, requirement gathering, and informing program design.
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Liaison with stakeholders within and outside of the Agency to define business requirements, workflows, data, and reporting requirements.
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Identify and report risks and issues on projects.
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Understanding and managing coding and rule configuration in the Medicaid Management Information System.
CT Medicaid Enterprise Technology System (CT METS):
One position is located in the CT Medicaid Enterprise Technology System (CT METS) division. CT METS is a long-term program that will implement Medicaid Enterprise System modules that support the Connecticut Medical Assistance Programs and will enable us to meet our mission of a Connecticut where all have the opportunity to be healthy, secure, and thriving. Duties and responsibilities of the position include but are not limited to:
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Act as Contract Lead and provide contract compliance and oversight which includes monitoring deliverables; ensuring complete and quality work is performed.
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Coordinate deliverable reviews with broader team.
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Day to day liaison and central point of contact for the contractor.
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Review and process Contractor invoices for payment.
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Assist with drafting contracts and/or amendments as needed.
Applicants interested in any/all of the above positions must apply to this posting. Applicants will be able to specify which of the above positions they are interested in at a later step in the recruitment process. Applicants must meet the Minimum Qualifications as listed on the job opening and must specify their qualifications on their application.
As a state employee, you will be open to a terrific work life balance and competitive benefits package. This includes; excellent health care, generous leave policies, a retirement plan, a deferred compensation program, and more!
Selection Plan
The minimum experience and training requirements must be met by the close date on the job opening, unless otherwise specified. Ensure that your application is complete before submitting it. You will not be able to make revisions once your application is submitted into the JobAps system.
This position will be filled in accordance with contractual language, reemployment, SEBAC, transfer, promotion and merit employment rules. Candidates currently holding the title of Health Program Associate, who have permanent status and wish to be considered for lateral transfer, are now required to submit their application for consideration. All Candidates who meet the Minimum Qualifications - as listed on the job opening - must submit an application and will be considered for this role, as determined by qualifications stated on the submitted application.
All State employees shall follow the guidelines as listed in Executive Orders 13F (3a) and 13G (3a).
Although applicants will receive correspondence via email, as a backup they are also encouraged to sign on to their Personal Status Board on a daily basis to monitor their status, view all emailed notices and complete tasks required in the recruitment process.
Note: At any point during the recruitment process, applicants may be required to submit additional documentation which support their qualification(s) for this position. These documents may include: a cover letter, resume, performance reviews, attendance records, supervisory references, licensure, etc., at the discretion of the hiring agency. Applicants must meet the minimum qualifications as indicated to apply for this position.
If selected for further consideration, State employees may be required to provide last 2 service ratings last 2 attendance records and non-state employees may be required to provide 2 current letters of professional reference.
This posting may require completion of additional referral questions (RQs) which will be sent to you via email after the closing date. The email notification will include an expiration date by which you must submit (Finish) your responses. Please regularly check your email for notifications. Please check your SPAM and/or Junk folders, as emails could end up there in error.
Interviews will be limited to candidates whose experience and training most closely meet the requirements of the position. The immediate vacancy is listed above, however applications to this recruitment may be used to fill future vacancies in this job classification.
Should you have any questions pertaining to this recruitment, please contact Elizabeth Weston at Elizabeth.Weston@ct.gov.
PURPOSE OF JOB CLASS (NATURE OF WORK)
In a state health program or project, this class is accountable for performing high level work in the implementation and coordination of the non-clinical aspects of health care programs or projects.
EXAMPLES OF DUTIES
The specific duties and responsibilities of this generic class vary widely depending on the nature of the program and the current stage in its life cycle. Typical examples of duties include the following: serves as regional coordinator for a statewide health program or project with responsibility for developing and maintaining appropriate programs, projects and liaisons in their assigned regions; participates in planning, organization and implementation of a statewide health program by having responsibility for major components of program such as staffing, work assignment and distribution decisions; initiates and oversees public relations efforts; establishes and maintains relationships involved in program within agency and with other state, community or public agencies; assists division head in expediting program; prepares comprehensive reports on planning and progress of program; develops objectives so program functions within cost estimates; analyzes, evaluates and interprets data; advises and participates in formulation of task forces within or outside agency and coordinates activities so program is successfully accomplished; works with federal, state and community agencies on new, proposed or revised programs to clarify or develop objectives, determine method of integrating programs in agency operations and establish cost estimates; provides technical assistance to community agencies; assists in drafting of legislation and regulations; gathers fiscal and programmatic data on programs and participates in planning budget and programmatic aspects of program; may also be assigned to conduct health planning, program monitoring and grants management for particular programs; may be involved in approval of grants or projects; may speak publicly about program issues and develop information for public distribution; performs related duties as required.
KNOWLEDGE, SKILL AND ABILITY
Considerable knowledge of purposes, plans, objectives and programs of public health agencies including changing patterns of preventive medicine and environmental health; considerable knowledge of relationships between risk factors and evidence of health problems; considerable knowledge of changing aspects of social-medical philosophies; knowledge of research and evaluation design methodologies; knowledge of state and community organizations and programs involved in field of public health and medical care; considerable oral and written communication skills; interpersonal skills; considerable ability to plan, organize and direct a complex technical program; ability to analyze, evaluate and interpret data; ability to lead and train staff.
MINIMUM QUALIFICATIONS - GENERAL EXPERIENCE
Seven (7) years of professional experience in a health organization.
MINIMUM QUALIFICATIONS - SPECIAL EXPERIENCE
One (1) year of the General Experience must have been in health care program administration, a health systems agency or other health care organization in at least one of the following areas:
1. grant writing or monitoring;
2. formal program planning, development, management or evaluation;
3. program consultation;
4. public relations activities.
For State Employees, this is interpreted at the level of Health Program Assistant 2.
Note: A health care organization is defined as a large multi-dimensional agency with responsibility for developing health programs.
MINIMUM QUALIFICATIONS - SUBSTITUTIONS ALLOWED
1. College training may be substituted for the General Experience on the basis of fifteen (15) semester hours equalling one half (1/2) year of experience to a maximum of four (4) years for a Bachelor's degree.
2. A Master's degree in health education, hospital administration, public administration, public health or other closely related field may be substituted for one (1) additional year of the General Experience.
3. For State Employees one (1) year as a Health Program Assistant 2 may substitute for the General and Special Experience.
PREFERRED QUALIFICATIONS
- 2 or more years of experience with CT Medicaid current programs, policies and the Medicaid Management Information System.
- Experience with Medicaid Policy and Regulations especially around provider enrollment and claims processing.
- Experience with the Medicaid Data Warehouse.
- Experience describing current program requirements for the purpose of developing specifications for system development.
- Experience problem solving or troubleshooting issues related to the administration of program policies and requirements.
- Experience procuring, developing, implementing and/or managing large scale contracts, in excess of $1,000,000.
SPECIAL REQUIREMENTS
Incumbents in this class may be required to travel.
Conclusion
AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER
The State of Connecticut is an equal opportunity/affirmative action employer and strongly encourages the applications of women, minorities, and persons with disabilities.