Departmental Analyst Trainee -P11 - Program Review Division

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.

In a learning capacity, this position is identified as the compliance data analyst for the Program Review Division (PRD). This position conducts research and analysis of prior authorization data and regulatory requirements related to health care prior authorization (PA) requirements for fee-for-service (FFS) Medicaid/Children’s Special Health Care Services (CSHCS). This position identifies compliance issues and establishes recommendations for program policies and operational procedures/strategies in order to improve efficiency, effectiveness, and provision of technical knowledge regarding coverage inquiries.

This position interprets data and prepares reports of analytical findings, statistical summaries and conducts correspondence related to PRD compliance with MDHHS policy, state, and federal regulations. This position may rely on consultation with management for issues of higher-than-normal complexity such as broad-ranging implications beyond PRD (claims implications or potential need for amendment to Health Services policy or State Plan). This position will participate as an alternate to ensure operational turnaround time is met.

This position is identified as the compliance data analyst for the Program Review Division (PRD). This position conducts research and analysis of prior authorization data and regulatory requirements related to health care prior authorization (PA) requirements for fee-for-service (FFS) Medicaid/Children’s Special Health Care Services (CSHCS). This position identifies compliance issues and establishes recommendations for program policies and operational procedures/strategies in order to improve efficiency, effectiveness, and provision of technical knowledge regarding coverage inquiries.

This position interprets data and prepares reports of analytical findings, statistical summaries and conducts correspondence related to PRD compliance with MDHHS policy, state, and federal regulations. This position may rely on consultation with management for issues of higher-than-normal complexity such as broad-ranging implications beyond PRD (claims implications or potential need for amendment to Health Services policy or State Plan). This position will participate as an alternate to ensure operational turnaround time is met.

In a learning capacity, this position is identified as the compliance data analyst for the Program Review Division (PRD). This position conducts research and analysis of prior authorization data and regulatory requirements related to health care prior authorization (PA) requirements for fee-for-service (FFS) Medicaid/Children’s Special Health Care Services (CSHCS). This position identifies compliance issues and establishes recommendations for program policies and operational procedures/strategies in order to improve efficiency, effectiveness, and provision of technical knowledge regarding coverage inquiries.

This position interprets data and prepares reports of analytical findings, statistical summaries and conducts correspondence related to PRD compliance with MDHHS policy, state, and federal regulations. This position may rely on consultation with management for issues of higher-than-normal complexity such as broad-ranging implications beyond PRD (claims implications or potential need for amendment to Health Services policy or State Plan). This position will participate as an alternate to ensure operational turnaround time is met.

Possession of a bachelor's degree in any major.

No specific type or amount is required.

One year of professional experience.

Tw…