Special Enrollments Supervisor (PSA Opt 1)

at Department of Healthcare and Family Services in Springfield, Illinois, United States Job Description Essential Functions Subject to management approval, serves as Special Enrollments Supervisor by planning, directing, and evaluating the Special Enrollments Unit for the Bureau Serves as working supervisor Develops, directs and reviews management studies that identify and implement new data elements for the Provider Database, as it relates to Section programs Interprets Medicaid policies and the specifics of the section and other agency incentive programs to Department staff, officials, the medical community, and other agencies Organizes, directs, and manages the establishment of Provider Database records for newly approved providers Implements process to terminate or suspend providers that are convicted or found guilty of fraudulent Medicaid billing by the department’s Bureau of Medicaid Integrity, the U.S. Department of Health and Human Services, and/or the Department of Professional Regulations Serves as backup to the Provider Enrollment Services unit supervisor Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above Minimum Qualifications Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college Requires prior experience equivalent to three (3) years of progressively responsible administrative experience in a public or business organization Specialized Skills Three (3) years of professional experience in provider enrollment, credentialing providers into a large medical health plan Three (3) years of experience with applications such as Medicaid Management Information System ( MMIS ) databases, provider database, payee database or data warehouse database, including maintenance and upgrades Preferred Qualifications Three (3) years of professional experience in provider enrollment, credentialing providers into a large medical health plan Three (3) years of experience with applications such as Medicaid Management Information System ( MMIS ) databases, provider database, payee database or data warehouse database, including maintenance and upgrades Minimum of three (3) years of experience interpreting Medicaid policies to ensure compliance with state and federal mandates and guidelines Minimum of two (2) years of professional experience utilizing public or business administration, principles and practices Minimum of two (2) years of experience supervising staff, providing employment motivation and development Conditions of Employment Requires completion of a background check and self-disclosure of criminal history Requires the ability to utilize and maintain state issued equipment such as a laptop The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description To view full details and how to apply, please login or create a Job Seeker account