Program Specialist III, IV - Medicaid Reimbursement Section

$58,296 - $76,788/Yr

Hawaii State Department Of Education - Honolulu, HI

Full-time - Mid Level

Honolulu, HI

About the position

The Program Specialist III, IV positions at the Hawaii State Department of Education focus on supporting the Medicaid Reimbursement Section within the Office of Student Support Services. These roles are responsible for maximizing Medicaid reimbursements through program support, audits, and compliance with federal and state regulations. The positions aim to enhance the social, emotional, and physical well-being of students and their families by ensuring effective reimbursement processes.

Responsibilities

• Conduct internal and external audits of Medicaid-related activities in compliance with CMS and the Hawaii Department of Human Services Med-Quest Division.
• Provide program support for Direct Service Claiming (DSC) and Medicaid Administrative Claiming (MAC) programs to maximize Medicaid reimbursement.
• Research and review DSC and MAC programs in other states to develop best practices for the Department's Medicaid reimbursement programs.
• Conduct periodic reporting on outcomes, status, and long-term trends of MRS auditing results.
• Serve as an assistant liaison with internal and external departments, agencies, or stakeholders.
• Coordinate responses to external audits to ensure timely and accurate responses and maintain a record retention system.

Requirements

• Must meet all requirements for the position as of the application date.
• Experience calculation is based on full-time, 40-hour workweeks; part-time experience is pro-rated.

Nice-to-haves

• Experience in Medicaid reimbursement processes.
• Knowledge of federal and state compliance regulations.

Benefits

• Salary range based on experience and qualifications.
• Potential for temporary positions to lead to permanent opportunities.