The Department of Human Services (DHS) is about safety, health and independence for all Oregonians. We help Oregonians in their own communities achieve well-being and independence through opportunities that protect, empower, respect choice and preserve dignity. We protect children who are abused or neglected. We serve seniors, people with disabilities. We help low-income people along the road to self-sufficiency with health coverage, job preparation, childcare and other supports. Our services are delivered in the least restrictive setting and in partnership with communities. We are absolutely committed to ongoing innovation in the delivery of services, and we are committed to recruiting, developing and retaining dedicated employees.
This employment opportunity is with Aging and People with Disabilities, Office of Federal Resource and Financial Eligibility/Provider Payments Unit, which is part of the Department of Human Services. There is one permanent full-time opening located in Salem (Summer St NE). This position is represented by a union.
This recruitment announcement will be used to establish a list of qualified candidates to fill the current vacancy and may be used to fill future vacancies as they occur.
Please be aware that due to the economic downturn and subsequent state budget short-fall these positions may be required to take furloughs in the biennium 2011-2013.
Duties & Responsibilities:
The Enrollment Specialist ensures that only certified, licensed or otherwise credentialed providers are enrolled in the Medicaid Management Information System (MMIS). The Enrollment Specialist adheres to the provider enrollment requirements established by the Affordable Care Act (ACA). Work is done both accurately and in a timely manner so providers may receive the appropriate reimbursement for services they provide to Medicaid DHS program recipients. This position, working together with management and provider relations analyst, develops new and adheres to established performance standards for enrolling DHS providers into the MMIS in accordance with established agency policies, state and federal rules and applicable regulations. Provides continuous monitoring of the enrollment process and the enrollment outcomes to ensure accurate outcomes for our applying providers. Updates provider information as necessary and communicates appropriately for accurate provider data on which MMIS program transactions are based.
Consistently treats customers, stakeholders, partners, vendors and co-workers with dignity and respect. Creates and maintains a work environment that is respectful and accepting of diversity. Sets clear guidelines and models expected office professional behaviors. Establishes and maintains clear methods for reported inappropriate actions.
Coordinates and monitors all provider enrollment activities including:
Function as an enrollment operations expert by;
- Follows established procedures to enroll and update DHS providers within the MMIS in compliance with all state and federal rules, DHS policies, program requirements and regulations.
- Notifies the management of any issues encountered during these enrollment activities.
- Provide training to new enrollment staff, including orientation to unit enrollment policies and procedures, for all enrollment functions as directed.
- Responds to enrollment questions regarding processes, rule changes, and operational policies to both internal and external customers.
- Research applicable rules, regulations and policies as directed to ensure all providers are enrolled accurately and in accordance with specific program requirements.
- Participate with state and federal entities on possible fraud / abuse issues and/or investigations as directed.
- Verify and maintain electronic documentation of provider information used in enrolling, revalidation, and on-going maintenance of MMIS.
- Periodically review and monitor enrollment criteria and enrollment forms as directed. Participate in enrollment materials reviews as requested.
- Maintain established unit performance statistics and seek coaching assistance from the management as needed.
Other duties as assigned.
- Providing recommendations, problem solving, advice, direction and decisions when judged necessary or when solicited by customers.
- Corresponding professionally with customers by e-mail, phone, and regular mail.
- Regularly attending and actively participating in unit staff meetings and huddles.
- Being open to receive constructive feedback from coworker and Manager.
- Timely and accurately resolving enrollment discrepancies when identified through quality reviews or inquiries by internal and external customers.
- Periodically reviewing provider and DHS enrollment rules and initiating changes to procedures when deemed necessary to ensure the integrity of the specific programs.
This position works the standard work week within general office conditions. Requires a valid driver's license or other acceptable form of transportation. Occasional adjusted work schedule.
Qualifications & Desired Attributes:
Your application materials, including your answers to the 'Supplemental Questions' will be reviewed to determine if you meet the minimum qualifications and how you meet the desired attributes for the position to which you have applied. Your answers to the supplemental questions must be reflected in your application.
Three years of experience performing public contact and/or customer service duties comparable to the work of a Public Service Representative.
At least two years of this experience must include dealing with the public in-person or by phone providing information about services and programs; explaining rules, programs, and procedures; and/or providing assistance, explaining requirements, and gaining compliance.
Experience with a high volume of paper work (e.g., assuring information on forms is complete and accurate, completing necessary documents, etc.).
Experience working in a high production environment in which it was necessary to accurately process large volumes of work on a daily basis within tight time constraints.
Experience reviewing applications, forms or other documents for compliance with established criteria.
Experience obtaining additional information from customers via telephone, in person and/or in writing.
Experience providing customer services that included providing general and procedural information via telephone, in person and/or in writing.
Experience dealing with hostile or difficult situations and communicating with and resolving disputes with clients or customers.
Experience in processing, entering, and/or verifying detailed data.
Experience using a computer/computer terminal to enter/retrieve data.
Experience reviewing documents and work for accuracy.
Only the candidates whose experience most closely match the qualifications and desired attributes of this position will be invited to an interview.
IMPORTANT NOTICE – Email Addresses Now Required
The state of Oregon is now requiring all applications have a valid email address.
If you do not currently have an email address and do not know where to go to get one please refer to our Applicant E-Recruit FAQ's web page. Click on the link below to go directly to question #14 to view several internet providers where you can get a free e-mail account. The state of Oregon does not endorse any particular provider.
Applicant E-Recruit FAQ's
If you are offered employment, the offer will be contingent upon the outcome of an abuse check, criminal records check and driving records check, and the information shall be shared with the DHS, Office of Human Resources (OHR). Any criminal or founded abuse history will be reviewed and could result in the withdrawal of the offer or termination of employment.
DHS will communicate with all applicants via e-mail.
If you need assistance to participate in the application process, you are encouraged to call 503-945-5698 (voice) or 503-945-6214 (TTY) between 8:00 a.m. and 5:00 p.m. (Pacific Time) Monday through Friday.
If you need assistance with adding attachments to your profile or to a specific job posting please go to Adding and Removing Attachments to a Profile and Job Posting for further instructions. This quick help guide can also be found on the State Jobs Page by clicking in the Applicant E-Recruit FAQ's then click on Applicant Profile Maintenance.
PLEASE CONSIDER JOINING US!
The Oregon Department of Human Services is committed to affirmative action, equal employment opportunity and workplace diversity.
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State of Oregon - 18 months ago