Eligibility Policy Analyst

We are currently seeking dedicated and detail-oriented individuals to join our team as an Eligibility Policy Analyst. As an Eligibility Policy Analyst on the PERM program, you will play a crucial role in ensuring the accuracy and compliance of Medicaid and CHIP eligibility policies. This remote position offers the flexibility to work independently while contributing to the success of our program.

Responsibilities:

Collaborate closely with the Project Director and Eligibility Manager to align policy efforts with project goals.
• Provide essential technical assistance to state staff and eligibility reviewers, ensuring consistent policy application.
• Utilize your program knowledge to identify and address eligibility policy issues, promoting efficient and accurate processes.
• Assist in identifying additional Eligibility Policy Analysts who possess the necessary criteria and experience.
• Demonstrate an in-depth understanding of Medicaid and CHIP eligibility principles and practices.
• Work independently to conduct thorough policy research, analysis, and recommendations.
• Uphold a high standard of customer service by addressing inquiries promptly and effectively.
• Ensure adherence to departmental policies, procedures, and guidelines.
• Comply with the Statement of Work (SOW) guidelines and CMS directives and regulations.
• Collaborate effectively within the PERM team, communicating at all levels.
• Attend departmental meetings and required education and training programs.

Qualifications:

• Ability to interpret Medicaid, CHIP, and state eligibility regulations and to analyze their impact on current and proposed programs;
• A minimum of three (3) years of experience conducting Medicaid/CHIP eligibility reviews;
• A minimum of five (5) related experience;
• Bachelor's degree or equivant;
• Experience conducting quality assurance activities related to Medicaid and CHIP eligibility case reviews; and
• Experience conducting eligibility reviews for the PERM or similar program.
• Considerable program knowledge of Medicaid and CHIP eligibility principles and practices.
• Strong organizational skills and meticulous attention to detail.
• Excellent customer service skills, with the ability to communicate policies clearly.
• Proficient in performing routine activities while adhering to deadlines.
• Self-motivated and capable of working effectively in a remote setting.
• Demonstrated ability to collaborate within a team-oriented environment.
• Exceptional written and verbal communication skills.
• Familiarity with CMS directives and regulations related to eligibility policies (preferred).

This remote position offers an excellent opportunity to contribute to the accuracy and efficiency of our Medicaid program's eligibility policies. If you are an independent thinker, possess a passion for detail, and thrive in a collaborative environment, we encourage you to apply.