Program and Projects Specialist 2
The incumbent in this position is a liaison between OIG, Law Enforcement entities, Other State Agencies, Health Plans, Internal divisions and the public. The incumbent will work closely with the Inspector General and Deputy Assistant Director providing updates on investigations, composing and sending correspondence to providers, requesting recoupment of overpayment and settlement monies. They are also responsible for processing and tracking all Provider Self Disclosures.
This position is required to maintain a direct, confidential working relationship with the Inspector General and the Deputy Assistant Director. This position will have access to confidential provider information, restricted disciplinary reports pertaining to medical professionals and member personal information protected by the Health Insurance Portability and Accountability Act (HIPAA). This position has no regularly assigned supervisor responsibilities.
- Review and analyze information obtained from referrals department receives; assess the allegations of referrals and determine its outcome.
- Provide communications to various parties. Obtains information from collateral sources such as other divisions, State Attorney General's office and other state agencies, law enforcement, providers, law firms, members, etc., to verify allegations.
- Prepares and maintains several tracking logs and reports. Maintaining financial tracking, spreadsheets, administrative lists and obtaining police reports. Enters cases into tracking system and assigns to investigators; maintains various tracking logs crucial to the HHS-OIG biannual audit; tracks and reports various financial matters for the Inspector General, manages self-disclosures.
- Analyzes data collected, composes written reports of investigative findings, and report findings to Provider Compliance Deputy Inspector General for case assignment. Planning, scheduling, prioritizing work activity; set up workload controls, determine priorities, monitor activity progress
- Communicates with health plans regarding referrals and other compliance matters
- Organizes the quarterly CONG meeting conducted by ZOOM attended by the health plans' corporate compliance officers and their staff. Numerous staff changes occur throughout the year and the invite list must be up to date for full compliance of attendees.
- This position is the direct contact for obtaining police reports for the entire agency.
- Special projects as assigned
About the Position:
- Prefers someone with progressive admin/exec assistant experience, who has extensive knowledge in spreadsheets, tracking documents, and communication skills.
- Ability to coordinate with internal and external customers/stakeholders while remaining and holding items to the utmost confidentiality.
- 100% On-site.
- Clean 7-year background check required.
- Training will be provided.
- Interviews will be conducted virtually.
To learn more, please contact Christine at firstname.lastname@example.org or call 602-788-5890.