Recruitment Number 211235 - Ewa, Oahu Employment Only - $3,798 to $5,624 per month (SR-22, Step C to M) for the immediate vacancy with the Department of Human Services, Med-Quest Division, Health Care Services Branch, Contract Monitoring and Compliance Section.
A continuous recruitment may be closed at any time. The notice of the last day to file applications will be posted on the Job Opportunities Listing page of our website.
Coordinates and participates in the administration of contracts entered into by the State's QUEST medical assistance program, including establishing contracts with assigned health plans and individual providers to provide comprehensive medical, dental, and behavioral health services to eligible individuals and families. Responsibilities also include working closely with divisional staff and representatives of the health plans in monitoring and evaluating the performance of contracted parties to assure compliance with the terms and conditions of the contracts; serving as a liaison for the State's medical assistance program with contracted parties, recipients, and other programs, agencies and/or individuals; coordinating and participating in the evaluation of contract proposals and recommending additional terms and conditions, if necessary; and participating in rate negotiations. Incumbents also participate in assessing administrative requirements and contribute in other areas based on the ongoing monitoring and evaluation of assigned health plans; are involved in the development of new medical assistance programs; and perform other related duties as assigned.
Minimum Qualification Requirements:
Applicants must meet all the requirements for the position they are seeking as of the date of the application, unless otherwise specified . In general, concurrent experiences and/or education will not be double credited unless otherwise specified. Your possession of the required amount of experience will not in and of itself be accepted as proof of qualification for the position. The overall paid or unpaid experience must be of such scope and responsibility as to conclusively demonstrate that you have the ability to perform the duties of the position. Our calculation of experience will be based upon a full-time, 40-hour work week. Part-time experience will be pro rated. Example: Twelve months of experience at 20 hours/week will be pro rated to six months of experience. Also, hours worked in excess of 40 hours/week will not be extra credited. Example: Twelve months of experience at 60 hours/week will be credited as one year of experience, not one and a half years.
To qualify, you must meet all of the following requirements:
Prerequisite Knowledge and Abilities Required:
Knowledge of: Health care delivery systems; current principles and practices in health care financing; principles and practices of contract administration; various provisions found in service provider contracts; evaluative techniques; problem solving methods and techniques; and report writing.
Ability to: Learn, interpret, evaluate and explain applicable laws, rules, regulations, policies and other technical materials; monitor and evaluate the performance of contracted parties to ensure compliance with the terms and conditions of the contracts; analyze and evaluate information, identify problems and develop alternative solutions; establish and maintain effective working relationships; communicate effectively orally and in writing; and prepare clear and concise reports and correspondence.
Education: A bachelor's degree from an accredited four-year college or university.
Excess Specialized Experience as described below or any other responsible administrative, professional or analytical work experience which provided knowledge, skills and abilities comparable to those acquired in four years of successful study while completing a college or university curriculum leading to a baccalaureate degree may be substituted on a year-for-year basis. To be acceptable, the experience must have been of such scope, level and quality as to assure the possession of comparable knowledge, skills and abilities.
The education or experience background must also demonstrate the ability to write clear and comprehensive reports and other documents; read and interpret complex written material; and solve complex problems logically and systematically.
Specialized Experience: Two and one-half years of progressively responsible professional work experience in the development and/or administration of contracts which significantly involved one or a combination of the following:
A. Preparing proposals or formal requests for proposals for contractual services which involved the application of professional judgment and analysis in determining contract terms and conditions and/or developing proposals to meet such requirements.
B. Evaluating, developing, negotiating, or revising the content of proposals and/or contracts.
C. Monitoring and evaluating the performance of contracted parties to ensure compliance with the terms and conditions stipulated in the contracts.
One year of the experience must have involved the development and/or administration of contracts for health care services.
Substitutions Allowed: A law degree from a school of law accredited by a nationally recognized specialized accrediting body (or course work deemed comparable by a nationally recognized specialized accrediting body) may be substituted for one year of Specialized Experience; however, it may not be substituted for the required one year of experience involving the development and/or administration of contracts for health care services.
The examination for this recruitment will be conducted on an unassembled basis where the examination score is based on an evaluation and rating of your education and experience. It is therefore important that your employment application provide a clear and detailed description of the duties and responsibilities of each position you held.
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