169210
MEDICAID PROGRAM MANAGER 1--B
AS621 $64,501 - $126,547
Creation Date: 08/29/2005
Change Date: 01/01/2025
FUNCTION OF WORK:To administer small and less complex statewide Medicaid program(s).
LEVEL OF WORK:SUPERVISION RECEIVED:Broad from a higher-level manager/administrator.
SUPERVISION EXERCISED:Supervision over lower-level position(s).
JOB DISTINCTIONS:Differs from Medicaid Program Monitor by responsibility for administering small and less complex statewide program(s) and supervision exercised.
Differs from Medicaid Program Manager 1-A by the presence of supervisory responsibility.
Differs from Medicaid Program Manager 2 by the absence of responsibility for administering medium size or moderately complex statewide program(s) and supervision exercised.
CORE COMPETENCIES:
IDENTIFIED BY STATE CIVIL SERVICE, CORE COMPETENCIES ARE THE KNOWLEDGE, SKILLS,
ABILITIES AND BEHAVIORS BASED ON THE WORK TASKS OUTLINED IN THE EXAMPLES OF WORK.
MORE INFORMATION ON THE SCS COMPETENCY MODEL CAN BE FOUND
HERE.
| Demonstrating Accountability | Developing Performance | Developing Plans |
| Driving Results | Following Policies and Procedures | Making Accurate Judgments |
| Managing Projects | Thinking Critically | Using Data |
EXAMPLES OF WORK:EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.
Supervises the auditing of eligibility enrollment of all Medicaid programs statewide.
Reviews work of eligibility review staff for quality assurance.
Plans, coordinates, and controls a small or less complex statewide program.
Plans, develops, implements and monitors comprehensive Medicaid program policies.
Conducts and directs studies/special projects pertaining to the programs assigned.
Analyzes the impact of federal, state, and local legislation; advises agency officials; prepares position statements; presents testimony at hearings; writes legislation.
Reviews and analyzes complex data and system reports to ensure compliance with program regulations.
Administers the day-to-day operational functions of the Medicaid fee for service programs. Assures that program policy and procedures are properly applies in accordance with federal and state laws and regulations.
Develops and writes agency rules and regulations governing the administration of all supervised Medicaid programs and submit them for publishing in the official state publication in accordance with the requirements of the Administrative Procedures Act.
Implements Medicaid regulations directing provider participation standards and recipient benefits. Analyzes multi-mullion dollar Medicaid claim data and project the fiscal impact for budget forecasting.
Identifies, verifies and analyzes the various revenue sources for the program(s). Determines and/or confirms match requirements. Monitors availability of revenue sources and promptly identifies existing or potential financing problems.
QUALIFICATION REQUIREMENTS:MINIMUM QUALIFICATIONS:
Seven years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
Six years of full-time work experience in any field plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
A bachelor's degree plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
An advanced degree or a Juris Doctorate plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.
EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.