Featured Job: Medicaid Health Systems Specialist

Job Duties

Under general direction, monitors & evaluates providers, projects, program (e.g., may include components) or service delivery by participation on or leads a team to &/or works independently to: Conduct complex analysis (e.g., researches & analyses policy, techniques & procedures for Just Cause & Waiver Disenrollment, Inpatient & Continuity of Care Deferments including reconciliation & reimbursement strategies for Medicaid-contracting Managed Care Plans [MCPs] & eligible consumers) determines & implements necessary Client Registry Information System – Enhanced (CRIS-E)/Medicaid Management Information System (MMIS) & other programmatical changes & discrepancies; monitors & evaluates program policies & procedures to assure compliance with federal & state regulations; summarizes findings & recommendations for change on health care related issues using complex computer systems [e.g., MMIS, CRIS-E, Decision Support System (DSS) databases] & initiates & completes complex, technical reports related to these issues; interacts directly with consumers, MCPs, providers & other interested parties in the compilation of data to determine appropriate MCP enrollment eligibility actions; notifies affected parties of actions (e.g., approval/denial of enrollment); verifies with consumers & providers that MCP follow-up action is completed by tracking concerns & resolutions; responds to inquiries by consumers, providers, county agencies, MCP & government officials by telephone, correspondence &/or in person.

Provides consultive expertise & training & acts as liaison to both intra-agency & inter-agency providers (e.g., Medicaid-contracting MCPs, Bureau of Community Services Policy); acts as team leader to gather & analyze data & in the design of required forms; consults with MCP officials, county agencies & other entities regarding current & forthcoming program changes; coordinates activities performed by other entities which are directly associated with the administration &/or implementation of policies pertaining to Medicaid-contracting MCPs; verifies reimbursements request & claims adjustments resulting from eligibility actions; represents agency at hearings, conferences, meetings & workshops; serves on committees & taskforces; prepares complex, technical reports, correspondences & memorandums.

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Manager Medical Management

Medical management and creative writing are the right combination of skills here.  Unique position will be instrumental in business expansion efforts nationally. Oversight for writing proposals from the med mgmt perspective, defining requirements, estimating and project planning for new business implementation and execution.    Creativity and professionalism will be essential in drafting proposals that adhere to established themes, writing guide and State, Federal and NCQA requirements. Research best practices, appropriate technological and logistical support. Will be instrumental in selecting and developing staff for new program implementation.

Must be able to travel for implementation of new business (varies 20-40%). Position requires nursing degree or Bachelor’s in related field, 3-5 years of writing experience including the ability to create business proposals and develop and implement business models. Project mgmt skills required. PMP a plus. Experience in managed care industry strongly preferred.

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Executive Recruiting Contact:
Pamela Ratz DeVille, CPC, CIR, CDR
DL: 866-371-0687 x256

6 Signs Your Job Interview Went Well

Right after a job interview, you’re going to feel pretty relieved that it’s all over and either confident that you did well or worried that you bombed. It’s common for job seekers to go over the job interview questions that they went through and the answers they gave, and note any other small things during the interview – but how do you really know whether or not you did well? Check out these 6 points below and you’ll have a better understanding of whether or not your job interview went well.

1. They give you a firm answer about when you’ll hear back.

This is not a foolproof indicator, but it’s a good one none the less. You don’t want to hear, “We’ll let you know.” You don’t want to have to ask, “When, exactly?” If they say, “I’ll have an answer for you on Monday morning,” that usually means they’ve made a decision. The decision might not be for you, but at least they’ve made a decision. This is sort of like a poker tell… if someone hasn’t made up their mind yet, they don’t really know how long it will take to do so, and thus are evasive about estimating how long it might take to make up their mind. If the interviewer gives you a vague answer, that might mean that there are plenty more interviews scheduled and your interview performance was not enough to make them cancel the others.

2. You covered topics beyond the job description.

A good interview is one where you handily answer all their questions, clearly demonstrate that you can meet all the job requirements, AND THEN start to discuss all the other things you can bring to the job. You win the job by using the interview to convince them that hiring you will bring them all sorts of additional dividends they didn’t even expect.

3. The interview went longer than scheduled.

This one is logical enough. If you’re in and out in a hurry, you might not have struck their fancy. But if you hang out for a while shooting the breeze (especially if you hit point number 4 below, that’s a good sign.

4. You discussed personal stuff.

This is maybe the best indicator. As I’ve said before, a job interview is largely about personality… even more so than skills or qualifications. If you start chatting away with the interviewer about this thing or that thing… if you’re sharing jokes and laughs, you’re probably home free. If you feel like the interviewer got to like you on a personal or professional level, that’s the best indication you can get.

5. The interviewer describes their frustration with the previous employee.

If the interviewer begins to talk about how poorly the last guy did in your position, then that’s a good indication that they’ve decided you can do a better job. If you find the interviewer comparing you favorably to previous or existing employees, then you’ve likely done a good job of selling yourself as qualified.

6. You begin plotting with the interviewer.

The best interviews I’ve ever had were the ones where we were already making plans for the things I would be doing once I started. I had not only sold myself, I had sold a game plan for the improvements I would be bringing to the position… and the interviewer had bought what I was selling. “I can’t wait for you to get started overhauling that inventory system. Do you think you might have any ideas for our shipping system as well?” That’s what you want to hear.Signs to look for during your job interview


Article provided courtesy of www.thejobbored.com