Healthcare Practitioner & Technical Worker/Medicaid Eligibility Supervisor (HCA/MAD )

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Job description

$23.07 - $36.91 Hourly

$47,989 - $76,782 Annually

This position is a Pay Band 65

Posting Details

This posting will be used for ongoing recruitment and may close at any time. Applicant Lists may be screened more than once.

This job posting may be used to fill multiple vacancies.

Our Vision

• Every New Mexican has access to affordable health care coverage through a coordinated and seamless health care system.

Our Mission

• We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Our Goals

• Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well-being of New Mexicans and the workforce.
• Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives.
• Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information.
• Build the best team in state government by supporting employees' continuous growth and wellness.

Why does the job exist?

The Medicaid Eligibility Supervisor will:

• Serve as Lead Processor reporting to the staff manager of the Application Processing Unit;
• Assist with all functions, activities and assignments in the Application Processing unit, including processing Medicaid applications received from prison and county jail inmates thru the Justice-Involved Utilization of State Transitioned Healthcare (JUST Health) program;
• Assist compiling reports and assisting state and county jail staff for the JUST Health Program;
• Work with Health Care Authority (HCA) and Medical Assistance Division (MAD) partners such as Children, Youth and Families Department (CYFD), New Mexico Department of Health (DOH), New Mexico Primary Care Association and other partners when required.

How does it get done?

The Medicaid Eligibility Supervisor is responsible for:

• Supervising staff, providing direction and leadership to staff within the Processing Unit;
• Working collaboratively with PE/JUST Health program unit staff;
• Assisting with inmate application questions and Presumptive Eligibility Determiner (PED) questions;
• Evaluating and processing Medicaid JUST Health program applications;
• Processing all APPRISS tasks from the Automated System Program & Eligability Network (ASPEN) by tracking active Medicaid cases to ensure benefits are suspended or reinstated per JUST Health program rules:
• Processing and completing Presumptive Eligibility (PE) task for Medicaid clients in ASPEN;
• Auditing and assisting PEDs by outreaching with support and following auditing process and procedures;
• Researching and resolving problem inquires received via-email or phone.

Who are the customers?

• Medical Assistance Division staff;
• Medicaid recipients;
• PED providers;
• Other state and federal government agencies.

Ideal Candidate

The Ideal Canidate has:

• Supervisor experience;
• Strong analytical and writing skills;
• Experience working with Microsoft Office;
• Excellent communication and customer service skills;
• Knowledge of the New Mexico Medicaid Program;
• Knowledge of State Personnel Act and State Personnel Board Rules;
• Knowledge of Public Employee Relations Rules, and Public Employee Bargaining Act and Collective Bargaining Agreements (CBA) for the State;
• Ability to adhere to strict deadlines;
• Skills for providing exceptional customer service.

Minimum Qualification

Associates degree in Business Administration, Healthcare Administration, Statistics, or Finance and three (3) years of experience with a public assistance program, medical, healthcare, educational or state facility working with policies and procedures, conducting analysis/research and/or providing or requesting information from the general public. Substitutions Apply. See Substitution Table below.

Substitution Table

These combinations of education and experience qualify you for the position:
Education Experience Education Experience 1 High School Diploma or Equivalent AND 5 years of experience OR High School Diploma or Equivalent AND 5 years of experience 2 Associate's degree in the field(s) specified in the minimum qualification AND 3 years of experience Associate's degree or higher in any field AND 5 years of experience 3 Bachelor's degree in the field(s) specified in the minimum qualification AND 1 year of experience 4 Master's degree or higher in the field(s) specified in the minimum qualification AND 0 years of experience
• Education and years of experience must be related to the purpose of the position.

• If Minimum Qualification requires a specific number of "semester hours" in a field (e.g. 6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications. No substitutions apply for semester hours.

Employment Requirements

Must possess and maintain valid driver's license.

Working Conditions

Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT), extensive personal computer and phone usage with extended periods of sitting. Must be able to lift 25lbs.

Supplemental Information

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Agency Contact Information: Jolene Jaffa . Email

For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.

Bargaining Unit Position

This position is not covered by a collective bargaining agreement.

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