Medicaid Program Specialist ; Certification Reviewer, PCN

Medicaid Program Specialist I, Certification Reviewer Eligibility

This position is open to Alaskan Residents only. Please check out the residency definition to determine if you qualify.

As the Medicaid Program Specialist I, Certification Reviewer, you will play a key role in the certification process for current and prospective Medicaid Home and Community-Based Services (HCBS) providers. You will be primarily responsible for reviewing and evaluating applications in accordance with applicable standards for HCBS providers (waiver and personal care services) who apply to obtain or maintain certification to participate in Medicaid.

You will review and analyze provider documentation and issue determinations on certification applications, track and trend issues with providers, and make recommendations for quality improvement activities. In addition, you will serve in a vital technical assistance role for providers as well as process changes in provider statuses during certification periods. Collaboration with appropriate partner agencies and referrals for inappropriate service provisions and/or non-compliance are also included in the duties of this position.

Some travel may be required.

Senior and Disabilities Services promotes health, well-being, and safety for individuals with disabilities, seniors, and vulnerable adults by facilitating access to quality services and supports that foster independence, personal choice, and dignity.

You will work with a talented, dedicated, and professional team that is driven to ensure quality services are provided to Alaska’s most vulnerable citizens so they can thrive in their home communities. Working within a team of nine staff and in very close collaboration with other teams at SDS as well as other partner agencies, there is ample opportunity to have a positive impact on the lives of Alaskans as well as gain valuable professional experience in the field of Medicaid compliance, certification, and quality assurance.

This position is located in East Anchorage, next to East High School. We are currently working in a hybrid teleworking model, with a 90-day in-person office requirement during initial hire and training. This position is mostly office/home based, however, some local travel may be required.

The ideal candidate will possess some or all of the following position‑specific competencies:

• Reading Comprehension: Understands and interprets written material, including technical material, rules, regulations, instructions, reports, charts, graphs, or tables; applies what is learned from written material to specific situations.
• Writing: Recognizes or uses correct English grammar, punctuation, and spelling; communicates information (for example, facts, ideas, or messages) in a succinct and organized manner; produces written information, which may include technical material, that is appropriate for the intended audience.
• Interpersonal
  
  Skills:
  
  Shows understanding, friendliness, courtesy, tact, empathy, concern, and politeness to others; develops and maintains effective relationships with others; may include effectively dealing with individuals who are possibly difficult, hostile, or distressed; relates well to people from varied backgrounds and different situations; is sensitive to cultural diversity, race, gender, disabilities, and other individual differences.

The State of Alaska complies with Title I of the Americans with Disabilities Act (ADA). Individuals with disabilities who require accommodations, auxiliary aids, or services, or alternative communication formats, please call in Juneau or TTY:
Alaska Relay 711 or or correspond with the Division of Personnel & Labor Relations at P.O. Box 110201, Juneau, AK . The State of Alaska is an equal‑opportunity employer.