Post Date: 01/31/2018
Close Date: 02/15/2018
*You must complete an online application to be considered for this position.
The Oregon Health Authority - Managed Care Delivery Systems Services Unit currently is seeking a Coordinated Care Organization (CCO) Account Representative (Program Analyst 2) to join our team. This position is responsible to assist with the establishment and monitoring, evaluations and maintenance of Medicaid and CHIP operational policies and procedures as they relate to the managed care process.
The Oregon Health Authority promotes health equity by developing policies and programs to eliminate health disparities and reach health equity for all Oregonians.
What you will do!
This position is responsible to provide program assistance and operational support to the statewide coordinated/managed care (CCO/MCO) programs. You will do this by working in collaboration with the CCO/MCO providing technical support, resolving technical issues affecting service delivery or access to care, and monitoring enrollment and eligibility. Also, you will work with Innovator Agents with respect to program and/or community resources coordination. This may require presentations to varying audiences.
In your role, you will analyze and provide recommendations related to delivery systems. This may be engaging in root cause analysis to identify trends affecting CCO/MCO, partners, providers, and members. You will also work in concert with Innovator Agents and Encounter Data Liaisons to resolve electronic transmission of data issues that affect enrollments or capitation files.
In this position, your extensive knowledge of CCO/MCO contracts and Oregon Administrative Rules (OARs) will be heavily relied upon as you make independent judgments/decisions to ensure access to quality health services. Your job entails working largely with the Oregon Health Plan (OHP) members as well as with its eligibility systems and processes.
A Bachelor's Degree in Business or Public Administration, Behavioral or Social Sciences, or a related degree; AND two (2) years of experience coordinating or administering a program related to THE OREGON HEALTH PLAN.
Any combination of experience or education equivalent to five years of experience coordinating or administering a program related to THE OREGON HEALTH PLAN.