Provider Analyst

at Department of Healthcare and Family Services in Springfield, Illinois, United States

Job Description

Position Overview

The Department of Healthcare and Family Services (HFS), Office of Inspector General (OIG), Bureau of Investigations, is seeking an experienced and qualified Provider Analyst to assist managing OIG’s New Provider Verification program. A large portion of the responsibilities within this position include planning, directing, and evaluating the providers that are referred from Provider Enrollment Services (PES)/Illinois Medicaid Program Advanced Cloud Technology (IMPACT). Serving as the program liaison, the Provider Analyst will also plan, direct, and evaluate program policies and procedures, assess data, and develop reports. The ideal candidate will be highly motivated, exhibit the ability to prioritize tasks to ensure timely work completion and possess excellent organization and communications.

HFS values employees with different backgrounds, life experiences, and talents. If you are seeking a new opportunity, and this position appeals to you, please apply today!

• Under direction, serves as a Provider Analyst by planning, managing, and evaluating a new Statewide Provider Verification program facilitating the enrollment of providers referred from Provider Enrollment Services (PES) / Illinois Medicaid Program Advanced Cloud Technology (IMPACT)


• Assesses data and related policy and procedural implications for inclusion in management studies relating to the program


• Plans, develops, and implements program functions


• Confers with management on all stages of the program


• Serves as liaison by communicating with IMPACT staff to sustain productive and professional relationships with other state agencies as well as other bureaus within the Department of Healthcare and Family Services


• Provides technical assistance on IMPACT to supervisory and investigative staff in obtaining information from various third-party resources


• Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above

• Requires knowledge, skill, and mental development equivalent to completion of four (4) years of college preferably with courses in business or public administration


• Requires one (1) year of responsible administrative experience in a public or business organization or completion of an agency approved professional management training program

• Requires two (2) years of knowledge of a case management system that tracks progress of various types of cases and manages data


• Requires two (2) years of knowledge of Illinois Medicaid Program Advanced Cloud Technology (IMPACT)

• Prefer a minimum of two (2) years of knowledge of a case management system that tracks progress of various types of cases and manages data


• Prefer a minimum of two (2) years of knowledge of Illinois Medicaid Program Advanced Cloud Technology (IMPACT).


• Prefer a minimum of two (2) years of knowledge of data warehouse management, such as the Case Administration & Search Enquiry (CASE) management system, utilized to manage incoming data


• Prefer a minimum of two (2) years of professional experience working with providers enrolling in a government program


• Prefer a minimum of two (2) years of professional experience managing a small agency function program


• Prefer a minimum of (2) years of professional experience analyzing administrative problems and adopting an effective course of action


• Prefer a minimum of two (2) years of professional experience exercising judgement and discretion in developing, implementing, and interpreting departmental policies and procedures

• Requires completion of a background check and self-disclosure of criminal history


• Requires the ability to travel in the performance of duties, with overnight stays as appropriate


• Requires the ability to utilize and maintain state-issued equipment such as a laptop

The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description

At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained. 

 

HFS is committed to promoting and preserving a workplace culture that embraces diversity and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer. 

Employees receive a robust benefit package including:

• Monday-Friday work schedule


• Flexible work schedules are available in many program areas.  (Remote work may be an option for certain positions.)


• Health, Life, Vision, and Dental Insurance


• Pension Plan


• Paid Parental Leave


• Deferred Compensation Program and other pre-tax benefit programs (Medical /Daycare)


• Employees earn (12) paid Sick Days annually.


• New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.


• Employees earn (3) paid Personal Days annually.


• (13-14) paid holidays annually (based on the start date)