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Member/Provider MCO Analyst

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Member/Provider MCO Analyst

Salary

$62,337.60 - $96,699.20 Annually

Location

Des Moines - 50319 - Polk County, IA

Job Type

Full-time

Job Number

25-03274

Agency

400 Health & Human Services - Medicaid

Opening Date

07/29/2025

Closing Date

8/8/2025 11:59 PM Central

LinkedIn Tag

#LI-POST

Point of Contact

Joanne Bush - [email protected]

+ Description

+ Benefits

+ Questions

Job Description

Only applicants who meet the Minimum Qualification Requirements and meet all selective requirements (listed below) will be placed on the eligible list.

The Iowa Department of Health and Human Services (HHS), Division of Medicaid, Bureau of Managed Care Reporting and Oversight is seeking a Member/Provider MCO Analyst to join our team!

In this role, you will support the oversight and monitoring of Managed Care Organizations (MCOs) to ensure they meet contractual requirements related to member and provider services. Responsibilities include analyzing reports and operational documents, identifying trends or areas of concern, supporting policy development, collaborating with internal and external stakeholders, and contributing to improvements in the quality and effectiveness of services delivered to Medicaid members and providers.

Key Responsibilities

+ Analyze MCO operations, policies, and reports (monthly, quarterly, ad hoc, and annual) to ensure compliance with contractual requirements, including participation in Readiness Reviews when applicable.

+ Assess the effectiveness of MCO programs and suggest operational changes to enhance service delivery and efficiency.

+ Develop meeting agendas and facilitate discussions with MCOs, internal teams, and external stakeholders.

+ Review Medicaid policies impacting members and providers, prepare responses to inquiries, and offer data-driven insights for program oversight.

+ Oversee performance-related issues and ensure timely, contract-aligned resolution.

+ Research and apply evidence-based practices to guide future program strategies and enhancements.

+ Participate in internal and external workgroups and meetings, providing subject matter expertise related to member and provider services.

If you're detail-oriented, data-savvy, and motivated to make a meaningful impact on healthcare programs across Iowa, we encourage you to apply!

Benefits

Working for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a

comprehensive benefits package designed to support your well-being and professional growth:

+ Health, Dental, and Vision Coverage:Health and dental insurance packages to keep you and

your family healthy at a low cost with outstanding coverage!

+ Paid Time Off:Take time to recharge with paid time off, including vacation (96 hours/year to

begin, increasing with years of service), sick leave (144 hours/year), and paid holidays (9

days/year).

+ Retirement Plans:Participate in retirement plans such as IPERS (employees contribute 6.29%

and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC),

Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to

$75/month).

+ Flexible Spending Accounts:Take advantage of flexible spending accounts for medical and

dependent care expenses.

+ Insurance Coverage:Benefit from life insurance and free long-term disability insurance for added peace of mind.

+ Employee Assistance Program:Access resources and support through our Employee

Assistance Program for personal and professional challenges.

+ Employee Discount Programs:Enjoy discounts on a variety of goods and services through our

employee discount programs.

For additional information on benefits click here.

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

Background Checks

Applicants will be required to complete a background check to be considered for this position.

The State of Iowa is an EEO/AA Employer

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 1-800-735-2942 TDD).

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.

Selectives

Human/Social Services Programs

6 months’ experience, 12 semester hours, or a combination of both directly related to human/social services. Experience generally obtained from either some level of government organization or a non-profit organization delivering these services. Must demonstrate exposure to the basic concepts of human/social services and related policies and procedures. Programs include those traditionally under the purview of the Department of Human Services, such as but not limited to: • Child and family welfare • Medicaid • Entitlement programs • Income maintenance • Mental health • Development disabilities • Child support recovery

Minimum Qualification Requirements

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

+ Graduation from an accredited four-year college or university with a degree in any field, and experience equal to three years of full-time work in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations.

+ All of the following (a and b):

+ Three years of full-time work experience in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations; and

+ A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience.

+ All of the following (a, b, and c):

+ One year of full-time work experience in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations; and

+ A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience; and

+ A total of two years of graduate-level education and/or full-time experience (as described in part a), where twenty-four semester hours of accredited graduate college or university coursework in business administration, industrial management, statistics, natural science, or a closely-related field equals one year of full-time experience.

+ Current, continuous experience in the state executive branch that includes six months of full-time work as a Management Analyst 2 or two and a half years as a Management Analyst 1.

For additional information, please click on thislink to view the job description (https://das.iowa.gov/sites/default/files/hr/documents/class\_and\_pay/JobClassDescriptions/ManagementAnalyst3-00736-90736.pdf) .

Why Choose the State of Iowa?

At the heart of our commitment to excellence is a dedication to our most valuable asset – our employees. Discover the outstanding benefits that set us apart as an employer of choice.

Our Robust Benefits Package Includes:

Competitive Compensation:

Enjoy a competitive salary that reflects directly on your skills and expertise.

Keep in mind, your wage is just one part of your total compensation. Unlock the complete value of your employment with the State of Iowa by using our user-friendlyTotal Compensation Calculator (https://das.iowa.gov/media/3773/download?inline) .Gain insights into your comprehensive annual compensation, including salary and State-provided benefits.

Health and Wellness:

Prioritize your well-being with our comprehensive health plans, including medical, dental, and vision coverage. Enjoy the peace of mind knowing that the State of Iowa covers 90% of the premiums, providing you and your loved ones with excellent coverage at a remarkably low cost.

Retirement Planning:

We are proud to offer the Iowa Public Employees Retirement System (IPERS). A defined benefit plan, IPERS benefits are guaranteed for life, meaning once you retire, you will receive the same monthly benefit for the remainder of your life (once vested). We invest in your long-term financial well-being, so you can retire with peace of mind.Click here to learn more about IPERS (https://ipers.org/members) .

Paid Time Off:

Life is unpredictable, and at the State of Iowa, we understand the importance of work-life balance. Our leave policies, including paid holidays, vacation, and sick leave with unlimited accrual, ensure you have the flexibility you need for personal and family matters.

Professional Development:

Elevate your career with continuous learning opportunities. We support your growth through training programs, workshops, and tuition reimbursement.

Employee Assistance Program (EAP):

We care about your well-being beyond the workplace. Access confidential counseling, resources, and support through our Employee Assistance Program.

Diversity and Inclusion:

Be part of a diverse and inclusive workplace that embraces all backgrounds and perspectives. We believe diversity is a strength that drives innovation.

Join Us - Elevate Your Career:

Ready to elevate your career with the State of Iowa?Click here (https://iowa.attract.neogov.com/recruitment/p/benefits) to explore more about our unparalleled benefits and discover what makes us unique. Your success is our priority!

01

Do you understand that the answers to all of the following questions must be truthful, honest, and accurate to the best of your ability? Please read all questions and answers thoroughly and make sure you understand them completely.Ensure the answers to your questions match the information filled out on your application and the attachments you have uploaded. If the answers to your questions are inconsistent with your application information or uploaded attachments, you will be given zero points for the question.Knowingly misrepresenting the facts when submitting any information related to an application, examination, certification, appeal, or any other facet of the selection process will result in your disqualification from this application and future employment with the state of Iowa.

+ Yes - I understand and agree.

+ No

02

PLEASE READ CAREFULLY

Have you filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq?

+ No - I have NOT filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq

+ Yes - I HAVE filed a registration statement pursuant to the federal Foreign Agents Registration Act of 1938, as amended, 22 U.S.C. §611 et seq

03

Have you graduated from an accredited college or university with a Bachelor's degree in any field? IF YES - How many years do you have of full-time work in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations?

+ No experience in the identified areas

+ Less than one year of experience in the identified areas

+ One year to less than two years of experience in the identified areas

+ Two years to less than three years of experience in the identified areas

+ Three or more years of experience in the identified areas

+ Not applicable

04

If you are a CURRENT employee for the State of Iowa (executive branch) how many years of full-time experience as a Management Analyst 2 for the State of Iowa do you have?

+ No Experience as a Management Analyst 2

+ Less than 6 months

+ 6 months or more

05

If you are a CURRENT employee for the State of Iowa (executive branch) how many years of full-time experience as a Management Analyst 1 for the State of Iowa do you have?

+ No Experience as a Management Analyst 1

+ Less than 12 months of experience as a Management Analyst 1

+ 12 months to less than 18 months of work experience as a Management Analyst 1

+ 18 months to less than 24months of work experience as a Management Analyst 1

+ 24 months to less than 30 months of work experience as a Management Analyst 1

+ 30 months or more of work experience as a Management Analyst 1

+ Not applicable – I am not a State Employee

06

Do you meet A and B: A. Three years of full-time work experience in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations; and B. A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience.

+ Yes - I meet A and B

+ I do not meet A and B

07

Do you meet A, B and C: A. One year of full-time work experience in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations: and B. A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience; and C. A total of two years of graduate-level education and/or full-time experience (as described in part a), where twenty-four semester hours of accredited graduate college or university coursework in business administration, industrial management, statistics, natural science, or closely related fields equals one year of full-time experience.

+ I meet A, B and C

+ I do not meet A, B and C

08

Does your application demonstrate that you have 6 months' experience, 12 semester hours, or a combination of both directly related to human/social services? Experience generally obtained from either some level of government organization or a non-profit organization delivering these services. Must demonstrate exposure to the basic concepts of human/social services and related policies and procedures. Programs include those traditionally under the purview of the Department of Human Services, such as but not limited to:

+ Child and family welfare

+ Medicaid

+ Entitlement programs

+ Income maintenance

+ Mental health

+ Development disabilities

+ Child support recovery

+ Yes

+ No

09

If you answered "Yes" to the question above - please list exactly HOW you meet it: list exact classes and credit hours, employer, dates and hours per week and exact duties. Please do not paste or state - See application or resume. If you answered no to the question above please type in "No" in the box below.]

Required Question

Employer

State of Iowa

Website

hhs.iowa.gov

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