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Program Specialist (2867)

Medical Administrative Support Specialist | Harrisburg, PA | Contract

Job Description
Program Specialist
Work Location: Harrisburg, PA

Job Summary/Description
The Program Specialist for our client will assist in reviewing, tracking and monitoring Managed Care Organization (MCO) Prior Authorization policies for three MCOs, assist with monitoring and data analysis of Community Health Choices (CHC) MCO Services complaints and grievances, assist with CHC MCO Services fair hearings and appeals tracking/data analysis and submission of appeals information to the Bureau of Hearing and Appeals, and act as the lead for Level of Care determination submission monitoring including receipt and approval of determinations within specified timelines.

Job Duties/Responsibilities/Functions (including but not limited to)
• Reviews and recommends modifications to program manuals and materials based on policy revisions. Develop and update forms and files.
• Coordinates the collection of Data to prepare reports.
• May be Involved in provider recruitment, enrollment, dis-enrollment and outreach activities.
• May be Involved in incident reviews, closing incidents, reports and investigations.
• May be involved in fair hearing preparation.
• Participates in trainings, meetings and conferences on behalf of the Bureau as assigned.
• Assist in tracking information, reviewing reports, and preparing reports for the supervisor, CMS and Agency when needed.
• The employee will use HCSIS and CIS for screening, entering information, and researching information when needed.
• The employee may assist in monitoring of services provided to participants of autism programs.
• Performs other duties as assigned

Minimum Qualifications
• Associate degree or a combination of education and experience in developing, implementing or evaluating human service, public health care services or health care insurance programs.
• Maintain a Pennsylvania Driver’s license.

About InGenesis
InGenesis is dedicated to placing people in positions that preserve life, improve lives and inspire others. This does not happen without passionate people, skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. Founded in 1998, InGenesis manages thousands of employees, including pioneering healthcare, science, technology and pharma professionals. The workforce solutions company includes almost half of the Fortune 500 in its nearly 300 clients. It is recognized as one of the largest healthcare staffing firms, and InGenesis is the largest minority/women owned healthcare staffing firm in North America.

EEOC Statement
We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.