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DEDICATED TO STRENGTHENING THE HEALTH, SAFETY, AND INDEPENDENCE OF IDAHOANS

Applications will be accepted through 4:59 PM MST on the posting end date .

The Idaho Department of Health and Welfare, Division of Medicaid, is currently seeking a Program Supervisor with experience in Medicaid or other health care industry work including government or private health care.

As Program Supervisor, you will be responsible for the the team updating rates as supported by state appropriations, calculating payments, implementing reimbursement policy, collaborating with contractors, and ensuring compliance with federal and state laws and regulations. This position will complete oversight of activities related to Medicaid reimbursement for providers including Skilled Nursing Facilities (SNF), Intermediate Care Facilities for individuals with Intellectual disability (ICF/IID), Home and Community Based Services (HCBS), and hospice. This position works directly with internal and external stakeholders via email, in-person and virtual meetings, and phone calls. Stakeholders include but are not limited to division and department program support staff, provider groups, provider associations, third-party contractors, and the Center for Medicare and Medicaid Services (CMS) staff.

We are seeking highly-organized candidates with experience researching and analyzing documents to ensure compliance with federal and state laws, regulations, and accounting principles; supervising staff; communication and interpersonal skills; problem solving skills; critical thinking skills and team learning competencies.

This position may be eligible for limited telework after successful completion of probation and necessary training. Approval to telecommute is not guaranteed and subject to termination at any time.

BENEFITS:

The State of Idaho offers a robust total compensation and benefits package, including but not limited to:

+ We have one of the Nation's best state retirement systems (https://www.persi.idaho.gov/members-1/) (PERSI) that offers a lifetime benefit at retirement.

+ 11 paid holidays

+ Paid sick and vacation that begins accruing on your first day of employment; can be used immediately after accruing (no waiting time)

+ Paid parental leave (https://dhr.idaho.gov/information-for-state-employees/)

+ Medical, vision, and dental insurance benefits that become effective first of the month following your hire date. All contributions can be pre-tax (full-time/30+ hours per week)

+ 2 voluntary supplemental retirement plans including both pre-tax and Roth options

+ Deferred compensation plan

+ Life insurance for self, spouse, and children

+ Short and long-term disability insurance

+ Flexible Spending Accounts (FSA)

+ Wide variety of training opportunities

+ Some positions offer flexible hours and/or telecommuting

+ Additional perks and discounts (https://www.regence.com/producer/tools-for-members/advantages-discounts) available through medical provider

+ Public Service Loan Forgiveness (PSLF) Eligibility (https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service)

+ Employee assistance program

Additional information related to benefits and/or State programs can be found here: https://dhr.idaho.gov/StateEmployees/Benefits.html.*

EXAMPLE OF DUTIES:

+ Supervise staff to perform daily reimbursement tasks for SNF, HCBS, ICF/IID, Fiscal Employer Agents (FEA), fee schedules, managed care, and supplemental payment programs.

+ Review, understand, and apply federal and state rules, regulations, guidelines, and trends to make recommendations for policy changes related to healthcare billing and coding, Medicaid reimbursement activities, value care, and managed care.

+ Collaborate with policy and management to draft changes to rule, state plan, fee schedules, waivers, or provider reimbursement.

+ Reconcile, audit, approve and report on expenditures, budgets, provider reimbursement, and other financial data with internal and federal systems for completeness and compliance with reimbursement policy and agreements such as the Upper Payment Limit (UPL) for SNFs and ICF/IID; cost settlements; prospective payment systems; cost neutrality; rate reviews; and cost surveys.

+ Foster professional interpersonal relationships with other intergovernmental financial professionals, policy analysts, data analysts, and project managers within the department.

+ Provide technical guidance to Medicaid systems, internal staff, providers and stakeholders for reimbursement questions.

+ Support the development and maintenance of policies and procedures, contract monitoring, and procurement activities related to provider reimbursement.

+ Assist with routine rate setting functions for value care, managed care, fee for service, and supplemental payments across various provider types.

+ Process requests for hearings and administrative reviews for provider appeals.

+ Complete other duties, tasks, or assignments as assigned by management.

MINIMUM QUALIFICATIONS:

You must possess all the minimum qualifications below to pass the exam for this position. Please make sure your resume or work history supports your meeting the minimum qualifications for this position. Failure to do this may disqualify you from being considered for this position. It is highly recommended to attach a one-page cover letter to your application to demonstrate how you meet the requirements below.

+ Some knowledge of management practices. Typically gained through one year of work experience that included all the essential elements of management (planning, organizing, leading and controlling) OR completion of two upper division college-level courses, or approximately 60 hours of management training, that included all the essential elements of management AND six months of work experience performing all management elements.

+ Experience developing procedures and/or monitoring a budget. Typically gained by at least one year of experience developing procedures and/or monitoring a budget which included allocating expenditures, reconciling accounts and making fund transfers, or supervising these functions.

+ Experience supervising staff. Typically requires at least one year of experience where you were responsible for interviewing and selecting staff, providing work direction and training, evaluating performance, and generating employer problem solving solutions. Include the length of time, number and level of staff supervised.

+ Experience providing liaison with customer/provider groups. Typically gained by at least one year of experience working with one or more community groups of adults or liaison with customers and/or provider groups in a leadership role to share information, coordinate efforts and/or achieve shared goals.

+ Experience interpreting federal or state regulations. Typically gained by at least one year experience reviewing information or documents for compliance with laws and regulations OR explaining to others how laws and regulations apply to specific situations.

Below is preferred experience. It is not required for the position but applicants with this experience may receive consideration over other applicants.

+ Knowledge of Private or Public Healthcare. Typically gained by at least one (1) year of experience in a public or private health care setting, managed care setting, value care setting or insurance billing clearing house where use of medical codes was a function of the job.

+ Experience in business operations working with financial data, setting reimbursement rates, or budget oversight. Typically gained by at least one (1) year of experience working with large computer systems to process financial data or rate setting.

Learn About a Career with DHW (https://healthandwelfare.idaho.gov/about-dhw/dhw-careers)

If relocating to Idaho, the Department of Health & Welfare does not reimburse the cost of relocating and the department does not sponsor anyone with a work visa.

***PLEASE NOTE: application assistance is not available after the business hours listed below, on the weekends, or on holidays and you must apply before 4:59 pm on the closing date. When applying, use CHROME as your browser to avoid complications.

If you have questions, please contact us at:

Email is the quickest way to get an answer to your questions.

(answered Monday through Friday during business hours MST)

EMAIL: [email protected] PHONE: (208) 334-0681

EEO/ADA/Veteran:

The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.

The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email [email protected].

Preference may be given to veterans who qualify under state and federal laws and regulations.