Benefit Program Senior Specialist

The MO HealthNet Division has an opening for a Benefit Program Senior Specialist within the Operations - Managed Care Unit located in Cole County.

Semi-monthly salary: The current rate for this position is $2,020.69. Individual(s) selected for this position may receive a higher rate based on a pay differential (e.g. shift, or time-of-service pay).

Job Location: This position is located at the Howerton State Office Building; 615 Howerton Court, Jefferson City, MO

The Department of Social Services partners with families and communities to protect children, rehabilitate youth, and move families to self-sufficiency so that Missourians can lead safe, healthy and productive lives.

Why you’ll love this position: This is a great opportunity to learn more about Managed Care Enrollment while working with a great group of individuals. This job is not just about data entry, but requires experience in eligibility and enrollment to make determinations in complicated cases.

• Research, analyze, and evaluate system-generate reports showing discrepancies or necessary changes to the managed care eligibility and enrollment system. These reports may include the Capitation Error Report, the Overlapping Capitation Report, and backing up staff with technical reports on newborns, deceased individuals, inpatient status, aged-out participants, Medicare, etc.
• Demonstrate the ability to recognize emerging or previously unidentified system problems and present findings to management for evaluation.
• Research, review, initiate and ensure appropriate action is taken for processing disenrollment, reconciliation reports, capitation payments, and maintain necessary logs and correspondence.
• Answer phone calls from the managed care health plans, as well as answer emails from various constituents.

Minimum Qualifications:

Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)

Preferred Qualifications:

A candidate with experience processing cases in the Missouri Eligibility Determination and Enrollment System (MEDES) and the Family Assistance Management Information System (FAMIS). The candidate shall have a working knowledge of the Missouri Medicaid Information System (MMIS), and Children’s Division Family and Chi ldren Electronic System (FACES) is preferred. The successful candidate should also possess strong verbal and written communications skills, accuracy, and attention to detail as well as the ability to interpret MO HealthNet policies and the Managed Care rules and regulations.

Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here .

If you have questions about this position please contact: Michel Aubuchon at Michel.aubuchon@dss.mo.gov . If you experience accessibility issues while applying, please contact Courtney Hall at Courtney.A.Hall@dss.mo.gov .

Recruitment Area : Current DSS employees only.

Application Deadline : October 20, 20225

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• State of Missouri

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