169240
MEDICAID PROGRAM MONITOR
AS618 $52,645 - $103,293
Creation Date: 08/29/2005
Change Date: 06/30/2025
FUNCTION OF WORK:To perform advanced research, analyses, and/or policy management activities for Medicaid programs.
LEVEL OF WORK:SUPERVISION RECEIVED:Broad from a Medicaid Program Supervisor or above.
SUPERVISION EXERCISED:JOB DISTINCTIONS:Differs from Medicaid Program Specialist 2 by the presence of advanced research, analysis and policy management responsibility.
Differs from Medicaid Program Supervisor by the absence of supervisory responsibility.
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.
| Building and Supporting Teams | Communicating Effectively | Demonstrating Accountability |
| Focusing on Customers | Following Policies and Procedures | Leading Effective Teams |
| Making Accurate Judgments | Managing Budgets | Thinking Critically |
| Training Others | 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.
Conducts audits of eligibility enrollment applications; prepares reports on results of each audit.
Prepares, interprets and clarifies eligibility policies and procedures.
Revises rules, regulations, and procedures to meet changes in law or policy.
Compiles data and proposes budgets for subprogram studies and proposed legislation; determines programmatic impact and composes response for
fiscal statements and fiscal notes.
Reviews current and proposed state and federal regulations and/or revisions to those regulations for hospitals and home health providers.
Evaluates new and/or revised regulations to determine the impact to the state Medicaid program.
Reviews audits performed by the contracted auditor to determine compliance with federal and/or state policies and regulations, which affect allowable costs.
Coordinates compliance monitoring of Medicaid Application Centers statewide.
Receives, approves and schedules all requests for Application Center Representative training.
Advises and assists field staff in performing on-site monitoring reviews to ensure that the Application Centers adhere to federal, state and agency
rules and regulations.
Assist in negotiating contractual agreements with Application Centers.
Provides functional supervision over contract staff.
Monitors and evaluates training provided by contract staff.
Prepares the annual budget request utilizing the prescribed format and addendums issued by the Office of Planning and Budget. Prepares detailed analyses
and narratives supporting and/or justifying the request as submitted. Responds to requests for additional information and modifications to the budget during
the legislative approval process.
Trains staff of all Medical Vendor Administration sections in fiscal management, budget development and variance reporting.
Develops training module and provides essential guidance to managers regarding preparing accurate, pertinent and substantiated data.
QUALIFICATION REQUIREMENTS:MINIMUM QUALIFICATIONS:
Six 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 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; OR
A bachelor's degree 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; OR
An advanced degree or a Juris Doctorate plus two 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.