|Department||Health Care Authority|
|Date Opened||11/1/2019 08:00:00 AM|
|Filing Deadline||11/15/2019 11:59:00 PM|
|Full or Part Time||
This position is critical as Oklahoma Health Care Authority (OHCA) has a responsibility as the Single State Medicaid Agency to provide administrative oversight of the eight 1915(c) Home and Community Based Services waivers and Living Choice demonstration that serve some 30,000 qualifying Oklahomans.
This Senior Research Analyst position is integral to the operational and administrative activities of the Medically Fragile waiver program. The position is tasked with specific quality monitoring functions that are essential to ensuring safety and quality for members receiving home and community-based services. Additionally, this position provides supports for long term care programs for SoonerCare members. The position must develop and maintain the agency’s waiver program, policies and state plans within assigned area of expertise; to bring the state’s program into compliance with changes in state and federal laws and regulations, to develop the regulatory basis necessary for improvements to the program, to protect federal financial participation in the program, to protect the rights of members due process et. al., and to provide clear guidance to the agency and the public regarding the structure and operations of the program.
Further, this position supports the development and maintenance of comprehensive, integrated systems for recording quantifiable performance and productivity information including inputs, outputs and outcomes. Assists with the development and preparation of the annual reports to the Centers for Medicare and Medicaid Services, as well as other statutory and regulatory performance-based related reports. Assist waiver members with ongoing coordination of care through the service plan development process to ensure that members’ health, safety and welfare are met within the community.
*Conducting research, planning and coordinating activities related to 1915(c) waivers and policy.
*Manages reporting activities utilizing Atlantes, MMIS, 1915(c) Waiver Portal, , and access to facilitate the efficient use of staff time and resources.
*Prepares material pertinent to the analysis and evaluation of Medicaid members and providers and analyzes records to determine completeness of documentation.
*Reviews, compiles and analyzes complex statistical, financial, and other data. Identifies trends. Applies theoretical principles and uses sound judgment in preparing key performance measurement forecasts and projections.
*Investigates and resolves any program/service issues or barriers for members and monitors provider performance and contractual obligations.
*Reviews proposed legislation and recommends changes; may act as legislative liaison.
*Assists in coordinating reporting activities within the unit and with other divisions for agency-wide reporting and reviews.
*Reviews data for accuracy and completeness. Analyzes and interprets data, using statistical research programs or other methods and makes projections based on statistical inference.
*Conducts surveys, utilization analysis and evaluation research regarding programs and projects.
*Interface verbally and in writing in a professional and timely manner to members, providers, contractors and co-workers.
*Plans, develops and conducts training, seminars, or meetings as required; represents the agency at meetings, seminars, and conferences.
*Compiles and prepares managerial and public reports and presentations of performance for various stakeholder groups.
*Represents the agency and the unit, interacting with other governmental agencies and outside entities, and with individuals with varying levels of authority.
*Other duties as assigned.
This position will require some travel both by private vehicle and public conveyance.
EDUCATION AND/OR EXPERIENCE:
Bachelor’s Degree in Business, Sociology, Gerontology, Management, Finance, Political Science or a closely related field AND a minimum of two years (2) years in Medicaid, a managed care program or related health care program OR a minimum of two years of professional or technical administrative experience in business, health policy, or public administration; OR an equivalent combination of education and experience totaling six (6) years.
PREFERENCE MAY BE GIVEN TO CANDIDATES WITH:
*Experience in a managed care or related health care program
*Case management experience
*Experience in conducting research concerning the impact of 1915(c) waiver policy, rules, regulations or legislation
*Experience using Excel and/or PowerPoint
Veteran’s preference points apply only for initial appointment in the classified service.