Eligibility Audit Consultant Position Available In Wake, North Carolina

Eligibility Audit Consultant State of North Carolina

• Dept of Health and Human Services Wake County, NC Job Details Full-time $41,655
• $72,897 a year 14 hours ago Benefits Paid parental leave Health insurance Parental leave Retirement plan Qualifications Data analysis skills Mid-level Microsoft Office Bachelor’s degree 1 year Full Job Description Description of Work

• PENDING RECLASSIFICATION

• Position is Exempt from the State Human Resources Act

• G.S. 126

• Position is funded in part through federal funds.

This is a 100% remote position, although occasional travel and in-person onsite work hours may be required. Position is responsible for evaluating county actions made on erroneous eligibility determinations in applying Medicaid policy. Position thoroughly examines county eligibility error findings across state audits to accurately determine county corrective actions and the impact of erroneous Medicaid claims payments; coordinates and liaises with the local county department of social service agencies and other State departments to establish corrective audit procedures and enhance service provisions. Requires detailed assessments of program compliance by collecting, analyzing, and reporting data; conducts comprehensive assessment on identifying and mitigating risks, as well as on internal control processes; develops and evaluates the effectiveness and efficiency of corrective actions to ensure program compliance. Provide detailed assessments of program compliance by collecting, analyzing, and reporting data; conducts comprehensive assessment on identifying and mitigating risks in eligibility determinations. About the NC Division of Health Benefits (DHB): The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $27 billion in state and federal funds per fiscal year, DHB ensures that more than 108,000 enrolled providers are reimbursed for delivering covered services to 3.1 million beneficiaries. About the NC Department of Health and Human Services (DHHS): The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.

Compensation and Benefits:

The State of North Carolina offers excellent comprehensive benefits. Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis). Employees also receive paid vacation, sick, and community service leave. In addition, paid parental leave is available to eligible employees. Visit website for benefits. Knowledge, Skills and Abilities / Competencies Listed below are the knowledge, skills and abilities (KSAs) associated with the position. These KSAs, along with the minimum education and experience listed, are required in order to be deemed “eligible” for the position therefore you must provide supporting information, within the body of your application, to demonstrate your possession of each KSA listed. Qualified applicants must possess, and application must clearly reflect work experience that demonstrates the following: Demonstrated expertise in Medicaid policy, with the ability to independently research, interpret, and evaluate eligibility determinations across all Medicaid program areas. Skilled in data analysis and statistical reporting, with experience designing and managing systems for program-specific data collection, evaluation, and reporting. Proven ability to perform compliance monitoring and apply internal control principles to ensure adherence to organizational policies, regulatory requirements, and quality assurance standards. Management preference will be given to candidates with: Proficient in utilizing and analyzing data from NC FAST and

NC TRACKS

(MMIS) systems to assess beneficiary eligibility, claims history, and program integrity. Experience with Microsoft Office/365 Suite. Minimum Education and Experience Requirements Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See Education and Experience Equivalency Guide for details. Bachelor’s degree from appropriately accredited institution and one year of experience related to the area of assignment; OR an equivalent combination of training and experience. Supplemental and Contact Information The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer who embraces an Employment First philosophy which consists of complying with all federal laws, state laws and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about

DHHS:

https://www.ncdhhs.gov/. DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position. It is critical to our screening and salary determination process that applications contain comprehensive information. Information should be provided in the appropriate areas to include the beginning and ending dates of jobs worked, education with the date graduated, all work experience, and certificates / licenses. Resumes will not be accepted in lieu of completing this application. Answers to Supplemental Questions must refer to education or work experience listed on this application to receive credit. Degrees must be received from appropriately accredited institutions. Applicants seeking Veteran’s Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications. Applicants seeking National Guard Preference must attach a NGB 23A (RPAS) if they are a current member of the NC National Guard in good standing. If a former member of the NC National Guard, who served for at least 6 years and was discharged under honorable conditions, they must attach either a DD256 or NGB 22. If applicants earned college credit hours but did not complete a degree program, they must attach an unofficial transcript to each application to receive credit for this education. Applicants may be subject to a criminal background check. All candidates selected for positions considered “Positions of Trust” will be subject to a criminal background check. Applications for positions requiring specific coursework must be accompanied by a copy of the applicant’s transcript. Applicants with degrees not conferred at a United States college or university must attach verification that their degree is equivalent to a similar degree from a U.S. institution. The Office of State Human Resources uses the National Association of Credential Evaluation Services (NACES) as a referral resource for applicants who need to have their credentials certified as equivalent. For a list of organizations that perform this specialized service, please visit the NACES membership website at https://www.naces.org/members. Transcripts, degree evaluations and cover letters may be uploaded with your application.

NOTE:

Applicants will receive communication via email only for updates on the status of their application or any questions on their application. If there are any questions about this posting other than your application status, please contact Talent Acquisition at . For technical issues with your application, please call the NeoGov Help Line at 877-204-4442. If you have a technical issue with your Government Jobs account, please call their Help Line at 1-855-524-5627.

NOTE:

For temporary, contract or other supplemental staffing appointments: There are no paid leave, retirement or other benefits associated with these appointment types.

For permanent and time-limited appointments:

Eligible employees have benefits that include employee health insurance options, standard and supplemental retirement plans, NC Flex (a variety of high-quality, low-cost benefits on a pre-tax basis), and paid vacation, sick, and community service leave, to name a few. Paid parental leave is available for eligible employees. Some benefits require 30 + hours work/week for participation.