Provider Requirements Oversight Coordinator

NOTE: If you are a current permanent or time-limited NC State Government employee, you will not be considered for a temporary assignment. Temporary Solutions cannot accommodate dual employment.The positions are located in Raleigh – Wake County. There are no leave or retirement benefits offered. The positions are currently remote 100% but will be expected to work on Dix Campus 4 – 5 days per week when normal business operations resume. The number of days to work on-site is subject to change.
Hourly Rate: $19.04 to $25.00
(Hourly Rates are based on education, experience, equity, and budget)

Position Overview:

These temporary positions will assist the Division of Health Benefits (DHB) Provider Operations team. Provider Operations assumes responsibility for an extensive amount of oversight and structured monitoring activities of the Fiscal Agent, PHPs/Standard Plan, and Tailored Plan, in addition to other current/expected vendors in relation to Provider Enrollment, Provider Services, Service Level Agreements, and engagement with other high priority operational components.

Job Specific Responsibilities:

• Perform assignments to support the implementation of the NC Medicaid Managed Care Tailored Plan
• Respond to inbound questions from providers, contractors, or other interested parties related to the Tailored Plan utilizing information from the contract, policy papers, and other existing resources
• Serve as a Managed Care Program Liaison to include attending meetings, workgroup sessions, and staying abreast of operational developments
• Assist with the development of internal business procedures
• Timely completion of assigned monitoring activities by following written/verbal instructions as part of the Department’s oversight responsibilities
• Review inbound materials and documents submitted by vendors to determine compliance with requirements set forth by the Department and the Tailored Plan contract
• Other duties as assigned to meet Provider Operations’ goals and needs
• Lead internal small and large group trainings, as, necessary in areas of subject matter expertise

Knowledge, Skills and Abilities / Competencies

To receive credit for all of your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit. Qualified applicants must document on the application that they possess all of the following:

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  Ability to establish and maintain effective working relationships with employees, administrative officials, contracted vendors, providers, stakeholders, and the general public
• Ability to express oneself clearly and concisely in oral and written form
• Proven ability to interpret and apply complex Federal and State regulations and requirements
• Demonstrated strong proficiency in Microsoft Excel, Outlook, Teams, Word Demonstrated understanding of public or private health care delivery systems Experience collecting and analyzing healthcare data and information
• Ability to pay close attention to details and meet deadlines
• Ability to work independently and cross functionally within small and large groups
• Ability to identify opportunities for process improvements and perform in a manner which mitigates risk

Management Preferences:

• Experience working with Medicaid or other healthcare programs
• Experience working with contractors and collaborating with other business areas

Minimum Education and Experience Requirements

Master's degree in a discipline relative to the program from an appropriately accredited institution and two years of related experience; or

Bachelor's degree in a discipline relative to the program area from an appropriately accredited institution and four years of related experience; or

an equivalent combination of education and experience.