Medicaid Operations Coordinator

Qlarant

  • Easton, MD Dallas, TX
  • $43,022-56,021 per year
  • Permanent
  • Full-time
  • 1 month ago
Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.Best People, Best Solutions, Best ResultsJob Summary:Are you an experienced administrative assistant recognized for your attention to detail, organizational skills and ability to effectively communicate with a wide range of people? Do you have exceptional technical abilities to include proficiency in Microsoft Office and related applications? Do you approach your work with a sense of urgency and a desire to see it through to a timely completion? If yes, we've got the perfect opportunity for you! As an Operations Coordinator at Qlarant, you will be specific to the Medicaid team with an emphasis on Medicaid appeals and coordinates a variety of operational functions and coordinates activities across the business unit by performing the following duties. This position can be considered in our Dallas, TX office, Easton, MD office, or potentially remote for the right candidate.Essential Duties and Responsibilities include the following. Other duties may be assigned.
  • Liaison to CMS and other governmental entities to obtain/provide information, identify issues and assists with timely responses to inquiries regarding contract.
  • Responds to client inquiries via written or oral communications.
  • Ensures contract compliance by monitoring deliverables, contract requirements, and communicating Medicare change requests.
  • Works with other business units to ensure the effective coordination of objectives/deliverables, establish permissions in systems, perform quality review of deliverables to ensure compliance in accordance with applicable regulations within the scope of work, managing activities, and facilitating project by setting priorities.
  • Coordinate and manage the transition of workloads, and serve as the interface with other entities.
  • Contractor Administrator for CMSARTs system.
  • Writes reports, prepares presentations, and ensures the timely approval by Program Director of deliverables.
  • Provides training and technical advice to team members.
  • Coordinates new CMS User ID set ups and background verifications.
  • Works with Quality Director/Officer on ISO initiatives to improve operational systems, processes and policies to improve information flow, management reporting, business process and organizational planning.
  • Facilitates project logistics such as meetings, conference rooms, conference calls, etc.
  • Participates and/or leads internal/external committees as assigned.
  • Coordinates with internal staff and external partners regarding Medicaid appeals
Required SkillsTo perform the job successfully, an individual should demonstrate the following competencies:
  • Problem Solving - Identifies and resolves problems in a timely manner.
  • Customer Service - Responds promptly to customer needs; Responds to requests for service and assistance.
  • Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Includes appropriate people in decision-making process.
  • Planning/Organizing - Prioritizes and plans work activities; Organizes or schedules other people and their tasks.
Required ExperienceEducation and/or Experience
  • High school diploma or GED required
  • Associates Degree in business preferred; at least 1 years experience in an administrative position; or an equivalent combination of education and experience.
Other Qualifications
  • Prior experience working on government contracts essential.
  • Working knowledge of Medicare and/or Medicaid protocols for Fraud and Abuse investigations are preferred.
Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.To perform the job successfully, an individual should demonstrate the following competencies:
  • Problem Solving - Identifies and resolves problems in a timely manner.
  • Customer Service - Responds promptly to customer needs; Responds to requests for service and assistance.
  • Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Includes appropriate people in decision-making process.
  • Planning/Organizing - Prioritizes and plans work activities; Organizes or schedules other people and their tasks.
Education and/or Experience
  • High school diploma or GED required
  • Associates Degree in business preferred; at least 1 years experience in an administrative position; or an equivalent combination of education and experience.
Other Qualifications
  • Prior experience working on government contracts essential.
  • Working knowledge of Medicare and/or Medicaid protocols for Fraud and Abuse investigations are preferred.
Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.

Qlarant