Compliance Monitor 2- 00221469
Job Description
The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.
Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency’s three program divisions. DCH employees are based in Atlanta, Cordele and across the state.
DCH is committed to providing superior Customer Service and Communication, embracing Teamwork and fostering Accountability to ensure that our internal and external customers and stakeholders feel included, respected, engaged and secure.
The Department of Community Health is seeking qualified candidates for a Compliance Monitor 2 position with its Office of Inspector General. The Compliance Monitor II position will support the HIPP and CHIPRA program activities within the Third-Party Liability (TPL) Unit. This position will be responsible for quality control, monitoring, supporting the Unit and compliance of program deliverables from the TPL Vendor. The position collaborates with other TPL Team members to meet internal deliverables within the Office of Inspector General (OIG). This is a hybrid position that requires in-office and remote work with the approval of your supervisor. Your days of frequency in the office can change at any time during your employment based on the business needs of the organization.
Essential Duties and Responsibilities:
- Initiates weekly review and approval of the weekly HIPP and CHIPRA registers.
- Drafts preliminary audit findings for Vendor
- Performs Level 1 approvals each week
- Performs quality control reviews of Vendor data against MMIS and Vendor’s systems.
- Assist members with TPL inquiries and insurance updates.
- Evaluates data for quality and completeness.
- Responds to routine and special requests.
- Serves as backup to other TPL Team members as needed.
Preferred Qualifications:
Completion of a bachelor’s degree from an accredited college or university OR One year of experience at the lower level or position equivalent (GSP010) OR Four years of related analyst experience.
- Medicaid knowledge
- Medicaid Management Information Systems experience
- Detailed oriented
- Proficient with Microsoft Office applications Word, Excel, and PowerPoint.
EARN MORE THAN A SALARY! In addition to a competitive salary, the Georgia Department of Community Health offers a generous benefits package, which includes employee retirement plan; paid holidays annually; vacation and sick leave; health, dental, vision, legal, disability, accidental death and dismemberment, health and child care spending account.
Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered, but may not necessarily receive an interview. Selected applicants will be contacted by the hiring agency for next steps in the selection process. Applicants who are not selected will not receive notification.
THIS POSITION IS SUBJECT TO CLOSE AT ANY TIME ONCE A SATISFACTORY APPLICANT POOL HAS BEEN IDENTIFIED. APPLICATIONS WITHOUT WORK EXPERIENCE LISTED WILL NOT BE CONSIDERED. CURRENT GEORGIA STATE GOVERNMENT EMPLOYEES WILL BE SUBJECT TO STATE PERSONNEL BOARD (SPB) RULE PROVISIONS. THE POSITION MAY BE FILLED AT A LOWER OR HIGHER POSITION LEVEL.
This position is unclassified and employment is at-will. Candidates for this position are subject to a background history and reference check. For more information about this job contact: : http://dch.ga.gov