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1 Oct 2024

Full-Time Medicaid Member & Provider Services Manager

Oregon Health Authority – Posted by Oregon Health Authority Anywhere

Job Description

Do you have a desire to help people in Oregon who rely upon Medicaid and Oregon Health Plan to assure equitable access and reduce disparities? Are you passionate about co-creating a positive and collaborative working environment, supporting process improvement, knowledge sharing, and person-centered engagement? We look forward to hearing from you!

 

What you will do!

Medicaid Member Services Manager. The primary purpose of this position is to manage and direct the activities and day to day administration for Member Services which includes Client Enrollment Services (CES) and Client Services Unit (CSU) call center staff.

  • CES is responsible for researching, analyzing, validating and taking appropriate actions on enrollment requests for members into Coordinated Care Organizations (CCOs).
  • CSU is the call center responsible for answering and addressing questions, concerns and issues for Medicaid members.

 

Medicaid Provider Services Manager. The primary purpose of this position is to manage and direct the activities and day to day administration for Provider Services Unit (PSU) call center staff and Provider Enrollment Unit (PEU) call center and enrollment staff.

  • PSU call center is responsible for answering provider questions primarily on healthcare claims issues to help ensure OHP providers receive accurate and timely Medicaid payments.
  • PEU is responsible for screening and enrolling providers into the Medicaid system.  The call center is responsible for answering and addressing questions, concerns and issues for Medicaid providers regarding enrollment.

 

OHA values service excellence, leadership, integrity, health equity and partnership and has a strategic goal to end all health inequities by 2030.

 

What’s in it for you?

  • We offer exceptional medical, vision and dental benefits packages https://www.oregon.gov/oha/pebb/pages/alex.aspx
  • Paid Leave Days:
    • 11 paid holidays each year
    • 3 additional paid “Personal Business Days” each year
    • 8 hours of paid sick leave accumulated every month
    • Progressive vacation leave accrual with increases every 5 years
  • Pension and retirement programs
  • Optional benefits include short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
  • Click here to learn more about State of Oregon benefits.

 

WHAT WE ARE LOOKING FOR:

Minimum Qualifications

Four Years of lead work, supervision, or progressively related experience; OR one year of related experience and a Bachelor’s degree in a related field.

 

Desired Attributes

  • Preference may be given for the ability to read, write, speak and interpret English and one of the 5 most common languages in Oregon other than English (Spanish, Vietnamese, Chinese, Russian, and Korean) with full proficiency in a culturally humble manner.
  • Experience supporting the development and implementation of policies and programs
  • Specific knowledge of Oregon Administrative Rules and Oregon Revised Statutes
  • Specific knowledge of health services delivery systems; government health benefit programs, particularly Medicaid; and client rights related to those programs.
  • Experience with multi-line telephone (MLT) system.
  • Experience in operational management, tracking and oversight for larger scale efforts or program / team accountability.
  • Specific knowledge of business and management principles involved in strategic planning, resource allocation, leadership technique, iterative design, and continuous quality improvement strategies; including experience in effectively managing teams and fostering a trusting team culture.
  • Ability to provide organizational leadership
  • Demonstrated project management experience
  • Experience communicating qualitative and quantitative information, verbal and written
  • Advanced Microsoft Excel, Word, PowerPoint and Outlook skillset; and skilled use of collaboration tools such as Microsoft Teams, SharePoint, and Smartsheet.
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How to Apply

Complete the online application at oregonjobs.org using job number REQ-166353  Application Deadline: 10/14/2024 Salary Range: $5,409 - $8,372

Job Categories: Equal Opportunities. Job Types: Full-Time. Salaries: 80,000 - 100,000.

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