"Alerted.org

Medicaid Utilization Analyst 12 - HSA Psychotropic Medication Oversight Unit (FC-PMOU)

Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5143934)

Apply



Medicaid Utilization Analyst 12 - HSA Psychotropic Medication Oversight Unit (FC-PMOU)

Salary

$2,068.00 - $3,498.40 Biweekly

Location

Lansing, MI

Job Type

Permanent Full Time

Remote Employment

Flexible/Hybrid

Job Number

3901-26-HSA-MCMCS-001-EST

Department

Health and Human Services - Central Office

Opening Date

11/17/2025

Closing Date

11/24/2025 11:59 PM Eastern

Bargaining Unit

NON-EXCLUSIVE REPRESENTED EMPLOYEE (NERE)

+ Description

+ Benefits

+ Questions

Job Description

The MDHHS mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect and fairness. For more information, please visit our MDHHS Diversity, Equity, and Inclusion Plan.

Medicaid Utilization Analyst 12

This position serves as the recognized resource to identify foster care individuals with psychotropic medication regimens that require additional physician review, preparing the physician review materials, and then performing additional monitoring or follow-up required following the physician review. Physician reviews are required for complex psychotropic medication cases as part of the Michigan Department of Health and Human Services Foster Care Psychotropic Medication Oversight (FC-PMOU) Section policy FOM 802-1 which was mandated as a result of a lawsuit settlement agreement. This position collaborates with the Foster Care - Psychotropic Medication Oversight steering committee across Department administrations (e.g., Health Services and Permancy and Wellbeing) and makes recommendations for improving psychotropic medication oversight and physician reviews. This position also works with various teams to re-design and implement the physician review process into the currently scheduled-to-be created CCWIS program replacing the MiSACWIS program. To identify psychotropic medication regimens that require additional physician review according to policy, the Utilization Reviewer actively monitors Medicaid claims data. Cases identified are prepared and assigned by the Utilization Reviewer to the MDHHS psychiatrist performing foster care psychotropic medication physician reviews. To maintain compliance with the lawsuit settlement agreement and policy requirements, the Department relies on the medical/pharmacological expertise in this position to prioritize high-risk cases for immediate review. This position collaborates with the FC-PMOU Outreach Analyst and Data Specialist to gather data, prepare utilization reports, and then develops and disseminates procedure and technical guidance information to MDHHS external customers/stakeholders as a result of the cases that have required Physician Review and follow-up.

Position Description (https://MCSC.state.mi.us/AgencyPDFs/MEDUTALAA59N%20PD%20111725.pdf)

Job Specification

To be considered for this position you must:

+ Apply for this position online via NEOGOV; click on "Apply" in the job posting for instructions on submitting your electronic application. Hard copy applications are not accepted.

+ Relevant experience and/or education referred to in the supplemental questions must be documented in the resume, transcript and/or application to allow for accurate screening.

+ Attach a resume identifying specific experience and dates of employment. Dates of employment should include month and year and hours per week.

+ Attach a cover letter.

+ If applicable, attach a copy of an official transcript(s). We accept scanned copies of official transcripts. We do not accept web-based, internet, or copies of unofficial transcripts. Official transcripts provide the name of the institution, confirmation that a degree was awarded and on what date, and the registrar's signature.

Failure to complete any of the above items may result in your application not being considered. See instructions for attaching files here: Instructions (http://www.michigan.gov/documents/mdcs/New\_Online\_Employment\_Application\_Guide\_-\_First\_Time\_User\_446027\_7.pdf)

Required Education and Experience

Education

Possession of a bachelor's degree in audiology, dental hygiene emergency medical technician, medical records administration, medical technology, nuclear medicine technology, nursing, occupational therapy, pharmacy, physician assistant, physical therapy, radiologic technology, rehabilitation, respiratory therapy, speech pathology, or sports medicine.

Experience

Medicaid Utilization Analyst 9- No specific type or amount is required.

Medicaid Utilization Analyst 10- Two years of professional experience providing clinical patient care requiring documentation of services provided, patient progress, etc. (e.g. nursing/therapy services); or; one year of professional experience analyzing health services or health services utilization data equivalent to a Medicaid Utilization Analyst 9.

Medicaid Utilization Analyst P11 - Four years of professional experience providing clinical patient care requiring documentation of services provided, patient progress, etc. (e.g. nursing/therapy services); or; two years of professional experience analyzing health services or health services utilization data equivalent to a Medicaid Utilization Analyst, including one year equivalent to a Medicaid Utilization Analyst 10.

Medicaid Utilization Analyst 12- Three years of professional experience analyzing health services or health services utilization data equivalent to a Medicaid Utilization Analyst, including one year equivalent to a Medicaid Utilization Analyst P11.

Alternate Education and Experience

Medicaid Utilization Analyst 9-12

Possession of a bachelor's degree in allied health, health education, health sciences, health care administration, chiropractic, health care management, health systems management, and health studies and licensure/certification in a clinical health care field may be substituted for the education requirement.

Medicaid Utilization Analyst 12

Two years of experience as a Registered Nurse P11 or equivalent may be substituted for the education requirement.

Additional Requirements and Information

The physical location of this position isremote unless return to office requirement –400 S Pine St, Lansing, MI.Based on operational needs and within established limits, remote work and alternate or hybrid work schedule requests for this position may be considered.

Selected candidates who have been approved to work remotely or a hybrid schedule must complete that work within Michigan. Candidates should confirm work location and schedule at the time of interview.

Employees will be provided computers to perform state work. Phones may also be provided for necessary communications. If working remotely, employees will be responsible for providing other components of a remote office at their own expense, including:

+ A secure work location that allows privacy and prevents distractions.

+ A high-speed internet connection of at least 25 Mbps download and 5 Mbps upload.

+ Suitable lighting, furniture, and utilities.

The use of artificial intelligence (AI) software of any kind is prohibited in all areas of the selection process; including, but not limited to, responses to application questions, and responses to interview questions or exercises.

As a Condition of Employment: this position requires successful completion of a background investigation and a criminal records check.

The Department of Health & Human Services reserves the right to close this posting prior to its original end date once a sufficient number of applications have been received.

For information about this specific position, please email [email protected] . Please reference the job posting number in subject line.

Your application for any position does not guarantee you will be contacted by the Department/Agency for further consideration. Only those applicants interviewed will be notified of the results.

If you previously held status in this classification and departed within the last three (3) years, please contact Human Resources regarding your interest in a potential reinstatement. Reinstatement is not guaranteed or required.

Follow us on LinkedIn for more job opportunities!

MDHHSJobs #MDHHSJobs #Veteranfriendly #CareersWithPurpose #CommunityHeroes

MDHHS is proud to be a Michigan Veteran’s Affairs Agency (MVAA) Gold Level Veteran-Friendly Employer

Accommodations

If you require a reasonable accommodation to participate in the application or selection processes, please contact theADA coordinator (https://www.michigan.gov/ose/-/media/Project/Websites/ose/Contact/RACs.pdf) for the agency that posted this position vacancy.

State employment also offers rewarding careers where you can help Michiganders enjoy better lives. Many State of Michigan jobs offer alternate work schedules and remote-work options that can help give the flexibility you need. The State of Michigan has been recognized as a leading U.S. employer by new graduates from 2021-2023 and a best large U.S. and state employer. Recognized on the international stage for fostering positive employee engagement, the State of Michigan is a past recipient of a North America Government Agency Employees Engagement Award.

More details on benefits for our new hires are below:

Rewarding Work:State of Michigan jobs allow you to serve Michiganders in many different ways depending on your interests and skills. Help preserve and protect our environment and the public health; enforce state laws and regulations; advocate for children, families, and victims of discrimination; support our state’s military and veterans; rebuild our state’s infrastructure; or support other state agencies through our fiscal, IT, and HR systems.

Insurance Benefits:The State of Michigan offers health, mental health, dental, and vision insurance to eligible career employees, their spouses, and their children. The state also covers a life-insurance benefit of two times employees’ annual salary (up to $200,000). The state also offers long-term-disability insurance that can provide continuing benefits if an injury or illness prevents employees from working. More information is available at www.mi.gov/employeebenefits.

Retirement Programs:The State of Michigan offers 401(k) and 457 plans for new hires to save for retirement. The state will automatically contribute an amount equal to 4% of your pay to a 401(k) account. The state will also match up to 5% of your pay if you contribute to your 401(k) account. Your contributions vest immediately, and the state’s contributions fully vest after just 4 years. More information is available athttp://www.mi.gov/orsstatedc.

Vacation and Sick Leave:Eligible full-time employees receive between15 and 35 personal daysand 13 sick daysper year that may be rolled over to the following year if not used. Eligible employees also receive an additional day each year for community service or school functions.

Paid Parental Leave:Eligible employees can take 12 weeks of paid leaveimmediately after a birth or adoption to allow needed time together at home with a new child.

Paid Holidays:Eligible employees receive 13 or 14 paid holidays each year including New Year’s Eve and Day, Martin Luther King Jr. Day, Presidents’ Day, Memorial Day, Juneteenth, the Fourth of July, Labor Day, Election Day, Veterans Day, Thanksgiving, Thanksgiving Friday, Christmas Eve and Day.

Bonus Programs:Eligible employees with five years of service also receive annual longevity bonuses that grow as seniority increases. Some positions also may qualify for recruitment, retention, and performance bonuses or other special pay premiums.

Military Pay Differential:Employees in the guard or reserves may also qualify for supplemental pay benefits if miliary pay during qualifying duty is less than normal state pay. Prior military service may also allow seniority credits to accelerate eligibility for longevity bonuses and additional personal leave accrual.

Tax-Advantaged Programs:In addition to 401(k) and 457 retirement accounts, the state also offers flexible spending account (FSA), health savings account (HSA), and qualified transportation fringe benefit (QTFB) programs that can help you save money by reducing your taxable income.

Student Loan Forgiveness:Working for the State of Michigan may allow you to participate in programs that forgive the balance of qualifying student loans. Please view Student Loan Information (https://studentaid.gov/manage-loans/forgiveness-cancellation) to help determine if you could qualify is available from the U.S. Department of Education.

Tuition Reduction:Some colleges and universities offer savings to eligible employees and family members to further their education while working for the State of Michigan.

Professional Development: To help develop your career, programs are available to apply for reimbursement of up to $2,000 a year for education and training for college course credits and non-degree programs.

Alternative and Remote Work Schedules:Depending on the nature of their duties, many state jobs offer flexible work schedules and remote or hybrid telecommuting options that can help obtain the work-life balance that you seek.

Great Lakes and Great Times:Michigan boasts four Great Lakes, 11,000 inland lakes, 36,000 miles of rivers and streams, 20 million acres of forests, 100 state and national parks and recreation areas, 1,300 miles of bike trails, 6,500 miles of snowmobile trails, the second-most ski areas in the nation, 650 public golf courses, 600 campgrounds, and an international dark-sky park—just for starters. Our cities offer concerts and cultural events, storied sports teams, education hubs, vibrant downtowns, one-of-a-kind craft beverages, and renowned restaurants for every appetite. From urban centers to beach towns to the great outdoors, the opportunities are endless. With your state salary and benefits and Michigan’s affordable cost of living, you can explore all that Michigan has to offer.

Updated: 2/28/24

01

Do you possess one of the following? A bachelor's degree or higher in audiology, dental hygiene emergency medical technician, medical records administration, medical technology, nuclear medicine technology, nursing, occupational therapy, pharmacy, physician assistant, physical therapy, radiologic technology, rehabilitation, respiratory therapy, speech pathology, or sports medicine; OR a bachelor's degree or higher in allied health, health education, health sciences, health care administration, chiropractic, health care management, health systems management, and health studies AND licensure/certification in a clinical health care field; OR at least two years of experience as a Registered Nurse P11 or equivalent. If so, please attach a copy of your official transcripts and any applicable licensure/certification.

+ Yes

+ No

02

Do you possess experience with clinical patient care or documentation of patient care services? (e.g. nursing/therapy/medical records); or professional experience analyzing health services or health services utilization data? If you possess this knowledge and experience, you must document this in your application to allow for accurate screening.

+ Yes

+ No

03

Describe your experience working with relational databases, ad/hoc query software and your ability to analyze data. Providing examples of software used and data reviewed would be helpful.

04

From the list below, please select the following programs you have working knowledge or experience with.

+ Outlook

+ Word

+ Excel

+ Access

+ PowerPoint

+ None of the above

05

From the list below, please select the following programs you have working knowledge or experience with.

+ BiQuery

+ SQL Assistant

+ Power BI

+ Other

+ None

06

From the list below, please select the following programs you have working knowledge or experience with.

+ CHAMPS

+ MISACWIS

+ CC360

+ SIGMA

+ None

07

Please describe your experience documenting processes or procedures and/or developing communications to instruct others on new or changing processes or procedures.

08

Please describe in detail your understanding of HIPAA and PHI including when and how the sharing of this information is appropriate.

09

Describe a time when you needed to work cooperatively with someone that did not share the same ideas as you.

10

Do you have any objection to being finger printed or drug tested?

+ Yes

+ No

11

Do you have any substantiated cases of abuse or neglect reported on the Department of Human Services Central Registry?

+ Yes

+ No

12

From the options below, which accurately describes your current status? (A current state employee works for an actual state department such as the Department of Corrections, the Department of Transportation, etc.)

+ A current Michigan Department of Health and Human Services (MDHHS) employee

+ A Michigan Department of Health and Human Services (MDHHS) employee in layoff status

+ A current State of Michigan (non-MDHHS) employee

+ A State of Michigan (non-MDHHS) employee in layoff status

+ None of the above

13

Are you a current MDHHS employee classified as a Medicaid Utilization Analyst and interested in moving to the same class and level at this location?

+ Yes

+ No

14

Did you attach a cover letter and a copy of your resume to your application? (Failure to do so may result in your application being screened out.)

+ Yes

+ No

15

If applicable, did you attach a copy of an official college/university transcript to your application? (Failure to do so may result in your application being screened out.)

+ Yes

+ No

+ Not Applicable

16

*Please select from the options below: (Please note, actions that have been expunged, formal counseling, and layoff actions need not be reported.) Please select all that apply.

+ I have been dismissed within the last two years

+ I have resigned in lieu of discipline or dismissal within the last two years

+ I have been suspended without pay within the last two years

+ I have received a written reprimand within the last two years

+ I have received an unsatisfactory rating within the last two years

+ I have signed a last chance agreement with MDHHS within the last two years

+ I certify that none of the above circumstances apply to me

Required Question

Employer

State of Michigan

Department

Health and Human Services - Central Office

Address

Office of Human Resources

235 S. Grand Ave.

Lansing, Michigan, 48933

Apply

Please verify your email addressVerify Email