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169270
MEDICAID PROGRAM SPECIALIST 2
AS615     $40,914 - $80,267
Creation Date: 08/29/2005
Change Date: 10/01/2022

FUNCTION OF WORK:
To perform research and analysis related to Medicaid programs.
LEVEL OF WORK:
Experienced.

SUPERVISION RECEIVED:
General from a Medicaid Program Supervisor or above.
SUPERVISION EXERCISED:
None.
LOCATION OF WORK:
Department of Health and Hospitals, Medical Vendor Administration.
JOB DISTINCTIONS:
Differs from Medicaid Program Specialist 1 by the type of supervision received and the independence of action.

Differs from Medicaid Program Monitor by the absence of advanced duties of coordinating research, analysis and policy management of Medicaid programs.

Differs from Medicaid Program Supervisor by the absence of supervisory responsibilities.
EXAMPLES OF WORK:
EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Researches, analyzes and compiles data for various reports.

Provides assistance in response to inquiries from the general public and public officials relative to Medicaid eligibility, payments, policy and procedures.

Resolves discrepancies between the various recipient files and eligibility files and prepares corrections.

Reviews and analyzes data for corrective action, fiscal impact, etc.

Update and monitor system databases.

Maintains records, prepares reports and conducts correspondence relative to the program element assigned.

Researches and analyzes provider billing practices via complex system reports and/or on site visits and recommends sanctions in accordance with state and federal regulations.

Consults with Information Technology staff to assure policy is correctly reflected by system programming.
QUALIFICATION REQUIREMENTS:

MINIMUM QUALIFICATIONS:

A baccalaureate degree plus one year of professional level experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.

SUBSTITUTIONS:
Six years of full-time work experience in any field will substitute for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:

A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.

30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.
60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.
90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.
120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree will substitute for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience to substitute for the baccalaureate degree.


Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for the required year of experience on the basis of thirty semester hours for one year of experience: public health; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.

A master's degree in the above fields will substitute for the one year of required experience.

A Juris Doctorate will substitute for the one year of required experience.

A Ph.D. in the above fields will substitute for the one year of required experience.

NOTE:
Any college hours or degree must be from an accredited college or university.