Offers “Dxc Technology”

Expires soon Dxc Technology

Healthcare Provider Analyst

  • Internship
  • Madison (Dane)
  • Teaching

Job description

·  Job Description:

Under the general supervision of the Bureau of Children’s Services (BCS), this LTE position is responsible for establishing a protocol and procedure for receiving and reviewing County Waiver Agency (CWA) requests to authorize rates above the Children’s Long-Term Support (CLTS) Waiver Program state service fee schedule that will be implemented in July 2019. The position will develop this new process and criteria, and will be responsible for receiving, analyzing and adjudicating the CWA requests accordingly.  During the transition phase to the CLTS state service fee schedule, BCS anticipates this position will process approximately 1,000 requests.

GOALS AND WORKER ACTIVITIES

This position of the BCS Healthcare Provider Analyst will implement the state protocol for receiving, reviewing and adjudicating CWA requests to authorize rates above the newly published CLTS state service fee schedule, also known as service rate outlier requests, and work with state staff to disseminate information about the process. This includes defining what constitutes an acceptable outlier service rate.

Project Tasks

·  Review federal guidance and research other service claims payment systems to implement, review and update the protocol and criteria
·  Implement the Wisconsin based protocol for authorizing outlier service rates in line with federal authorities and program budget parameters
·  Work with the CLTS service rate-setting project team to implement the protocol
·  Provide outreach materials, training, and technical assistance to impacted stakeholders
·  Compile and analyze outlier request data by service category and work with project team to assess budget impacts
·  Establish a sustainable process for ongoing use by program teams following the transition period
·  Collaborate with internal and external stakeholders to effectuate the outlier process

QUALIFICATIONS, KNOWLEDGE AND SKILLS

·  Bachelor’s degree in related field or equivalent experience
·  2 years of applicable experience, preferably with a human service agency
·  Experience developing and implementing policy
·  Experience compiling and analyzing financial data, including analysis for impact preferred
·  Experience negotiating service rates for health care, community services or non-profit programs
·  Ability to interpret regulations and impact of decisions made
·  Ability to facilitate effective training and related resources
·  Knowledge of community-based waiver programs and services
·  Knowledge of the federal Centers for Medicare  & Medicaid Services (CMS) Home and Community-Based Services (HCBS) waiver program requirements preferred
·  Knowledge of Medicaid programs and cost allocation methodologies preferred
·  Skills and experience in providing training, technical assistance and monitoring
·  Experience developing standard protocols for ongoing operations
·  Excellent interpersonal and communication skills along with the ability to deliver constructive feedback in a diplomatic and professional manner
·  Excellent written and verbal communication skills
·  Strong organizational and time management skills.
·  Ability to make complex independent judgments and decisions within the scope of responsibility
·  Ability to interpret data to draw meaningful conclusions
·  Implement strategies to address issues
·  Ability to be customer-focused and quality-driven
·  Strong teamwork and collaboration skills
·  Adapt to change quickly and meet deadlines on multiple projects
·  Ability to develop reports for executives, program managers and others
·  Excellent computer skills; experience with Microsoft Word, Excel and PowerPoint software
·  Must possess a valid driver’s license, maintain adequate auto insurance for job-related travel, and ability to travel within Wisconsin and other states as necessary

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