Medicaid Contract Analyst
PacificSource

Bend, Oregon

Posted in Utilities
about 1 month ago



This job has expired.

Job Description

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.

Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Position Overview: Perform analytical functions on behalf of the Medicaid Administration Department related to Medicaid contracts and performance. Under limited supervision, assist Medicaid Administration staff in ensuring organizational adherence to contractual Coordinated Care Organization (CCO) performance requirements. Employ an effective and efficient organizational skill set to support departmental needs. Evaluate, monitor, and analyze CCO contract performance information to ensure consistent and compliant reporting, internally and externally. Working closely with CCO leadership and other stakeholders, the Medicaid Contract Analyst will keep internal and external stakeholders informed of CCO performance related to contract deliverables and reports.

Essential Responsibilities:

  • Lead and manage contracting projects as determined by Medicaid Administration and/or requests from the state.
  • Manage and maintain contract deliverable matrices for each contract type and all service areas to ensure internal stakeholders are constantly informed of changing and modified deliverables.
  • Coordinate and collaborate with internal and external stakeholders to support, evaluate, and analyze reporting consistent with Medicaid line of business priorities.
  • Evaluate and monitor data for consistency, accuracy, and alignment in contract deliverables and reports.
  • Ensure consistent data and formatting of deliverables and reports where data elements apply.
  • Comprehend and understand reporting and monitoring expectations in state contracts. This includes all Medicaid contract types: the CCO contracts with the Oregon Health Authority, Cover All Kids, and Choice Model Services, in each service area where PacificSource has contracts of this type with the State.
  • Primary responsibility to maintain and manage SharePoint to support contract deliverable tracking tools, the Medicaid Administration department site, and create additional sites or tools within SharePoint for other projects, as needed and as determined and supported by the strategic plan.
  • Work in collaboration with the Medicaid Contract Coordinator to ensure contract deliverables are assigned appropriately and consistently within company and state deadlines.
  • Offer process improvement recommendations related to contract deliverables and reports to ensure an effective and efficient method for reporting to Medicaid Administration.
  • Continually inform Medicaid leadership of CCO performance through the Medicaid Leadership Team meetings and other committees as needed.
  • Maintain collaborative partnerships with key PacificSource departments and leaders.
  • Assume a supporting role in working with providers, the State, and other partners.


Supporting Responsibilities:
  • Perform day-to-day tasks for the Medicaid Administration department as needed.
  • Meet department and company performance and attendance expectations.
  • Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  • Perform other duties as assigned.


Work Experience: Minimum four years of experience in the health care, managed care, or public health administration industry, with a focus in contracting and/or compliance, and/or equivalent experience required. Relevant knowledge in the following areas highly preferred: the Oregon Health Plan, health care operations, analytics, and demonstrated organizational skills.

Education, Certificates, Licenses: Bachelor degree in Business Administration, Health Administration or other related field.

Knowledge: Excellent organizational skills demonstrating efficient documentation methods. Demonstrated excellent written and verbal communication skills. Demonstrated successful communication and interpersonal skills. Ability to analyze and interpret contracts, statutes, state, and federal rules and regulations. Ability to effectively research and report out on Medicaid related information. Ability to be nimble in a fast-paced environment with competing deadlines. Demonstrated skills with the following software: Microsoft Office Suite (e.g. Outlook, Word, Excel, PowerPoint, Project, and Visio), Adobe or Foxit PDF software, SharePoint, and data analytics software.

Competencies
  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards


Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is possible approximately 10% of the time.

Our Values
  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for customer service.
  • We practice open communication at all levels of the company to foster individual, team and company growth.
  • We actively participate in efforts to improve our many communities-internally and externally.
  • We encourage creativity, innovation, and the pursuit of excellence.


Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.


This job has expired.


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