Medical Policy Program Manager

State of Iowa

  • Polk County, IA
  • $62,338-96,699 per year
  • Permanent
  • Full-time
  • 9 days ago
Job DescriptionOnly applicants who meet the Minimum Qualification Requirements and meet all selective requirements (listed below) will be placed on the eligible list.The Iowa Department of Health and Human Services (HHS), Division of Medicaid, Bureau of Quality Innovation and Medical Policy is seeking a Medicaid Pediatric and Early Prevention, Screening, Diagnosis and Treatment Policy Specialist (EPSDT) to join our team!Requirements:
  • Work Monday - Friday, 8:00 am - 4:30 pm
  • Report to the Lucas Building in Des Moines, located on the beautiful Capitol Complex, two (2) days per week
  • Hold a nursing degree and ability to be licensed in the State of Iowa
  • Have a valid driver's license
  • Occasionally travel to meet with external stakeholders and attend conferences
Desired experience with or knowledge of:
  • Medicaid policies and processes
  • Assessing, diagnosing and providing treatment for the medical needs of children, youth and young adults under the age of 21
  • Clinical knowledge in how to apply the benefits
  • Disaggregating information to internal and external stakeholders
Responsibilities include:
  • Reviews, revises, writes, plans, coordinates and oversees the activities and strategies for the implementation and operation of Iowa Medicaid policies
  • Collaborates, coordinates, communicates and consults with internal and external stakeholders (i.e. childcare providers, educators)
  • Defines program strategies ensuring activities meet contractual requirements including performance objectives and outcomes
  • Provides consultation, analysis and interpretation of federal and state rules, laws, regulation, and procedures related to Medicaid coverage and reimbursement
  • Develops and implements program goals, objectives, and performance standards related to policies and programs
  • Identifies and presents suggestions for changes to the existing program
  • Researches and reviews articles on clinical best practices
BenefitsWorking for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a comprehensive benefits package designed to support your well-being and professional growth:
  • Health, Dental, and Vision Coverage: Health and dental insurance packages to keep you and your family healthy at a low cost with outstanding coverage!
  • Paid Time Off: Take time to recharge with paid time off, including vacation (96 hours/year to begin, increasing with years of service), sick leave (144 hours/year), and paid holidays (9 days/year).
  • Retirement Plans: Participate in retirement plans such as IPERS (employees contribute 6.29% and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC), Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to $75/month).
  • Flexible Spending Accounts: Take advantage of flexible spending accounts for medical and dependent care expenses.
  • Insurance Coverage: Benefit from life insurance and free long-term disability insurance for added peace of mind.
  • Employee Assistance Program: Access resources and support through our Employee Assistance Program for personal and professional challenges.
  • Employee Discount Programs: Enjoy discounts on a variety of goods and services through our employee discount programs.
For additional information on benefits .to see how we compare with other employers or offers by using our Total Compensation Calculator.Background ChecksApplicants will be required to complete a background check to be considered for this position.The State of Iowa is an EEO/AA EmployerHHS values those with “lived experience” and encourages adults who were fostered as youth, foster parents, and/or parents who were in the DHS system to apply. Minorities, women, persons with disabilities and veterans are encouraged to apply (Hearing and Speech Impaired - Relay Iowa 1-800-735-2942 TDD).Our agency uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visitSelectives872 Registered Nurse Licensure as Registered Nurse in the State of Iowa by the Iowa Board of Nursing or licensure as a Registered Nurse in accordance with the Nurse Licensure Compact Administrator's Agreement of the National Council of State Boards of Nursing. More information regarding the Nurse Licensure Compact Administrators agreement of the National Council of State Boards of Nursing is available at: Nurse Licensure CompactMinimum Qualification RequirementsApplicants must meet at least one of the following minimum requirements to qualify for positions in this job classification: * Graduation from an accredited four-year college or university with a degree in any field, and experience equal to three years of full-time work in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations.
  • All of the following (a and b):
  • Three years of full-time work experience in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations; and
  • A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience.
  • All of the following (a, b, and c):
  • One year of full-time work experience in project management; management analysis; data science; business systems analysis; or professional-level program administration, development, or operations; and
  • A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience; and
  • A total of two years of graduate-level education and/or full-time experience (as described in part a), where twenty-four semester hours of accredited graduate college or university coursework in business administration, industrial management, statistics, natural science, or a closely-related field equals one year of full-time experience.
  • Current, continuous experience in the state executive branch that includes six months of full-time work as a Management Analyst 2 or two and a half years as a Management Analyst 1.
For additional information, please click on this .Why Choose the State of Iowa?At the heart of our commitment to excellence is a dedication to our most valuable asset - our employees. Discover the outstanding benefits that set us apart as an employer of choice.Our Robust Benefits Package Includes:Competitive Compensation:Enjoy a competitive salary that reflects directly on your skills and expertise.Keep in mind, your wage is just one part of your total compensation. Unlock the complete value of your employment with the State of Iowa by using our user-friendly . Gain insights into your comprehensive annual compensation, including salary and State-provided benefits.Health and Wellness:Prioritize your well-being with our comprehensive health plans, including medical, dental, and vision coverage. Enjoy the peace of mind knowing that the State of Iowa covers 90% of the premiums, providing you and your loved ones with excellent coverage at a remarkably low cost.Retirement Planning:We are proud to offer the Iowa Public Employees Retirement System (IPERS). A defined benefit plan, IPERS benefits are guaranteed for life, meaning once you retire, you will receive the same monthly benefit for the remainder of your life (once vested). We invest in your long-term financial well-being, so you can retire with peace of mind. .Paid Time Off:Life is unpredictable, and at the State of Iowa, we understand the importance of work-life balance. Our leave policies, including paid holidays, vacation, and sick leave with unlimited accrual, ensure you have the flexibility you need for personal and family matters.Professional Development:Elevate your career with continuous learning opportunities. We support your growth through training programs, workshops, and tuition reimbursement.Employee Assistance Program (EAP):We care about your well-being beyond the workplace. Access confidential counseling, resources, and support through our Employee Assistance Program.Diversity and Inclusion:Be part of a diverse and inclusive workplace that embraces all backgrounds and perspectives. We believe diversity is a strength that drives innovation.Join Us - Elevate Your Career:Ready to elevate your career with the State of Iowa? to explore more about our unparalleled benefits and discover what makes us unique. Your success is our priority!

State of Iowa