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MEDICAL ASSISTANCE CONSULTANT III

We continually strive for a workforce that reflects the growing diversity within the State of Illinois. A variety of employee backgrounds, perspectives, ideas and experiences are crucial to our ability to most effectively serve the public. Bilingual skills welcome

Reasonable Accommodation Statement

The State of Illinois is committed to working with and providing reasonable accommodations to people with disabilities. Further, federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job, interview for a job, or for any other activity related to the hiring process. Examples of reasonable accommodation include, but are not limited to, making a change to the application process (if possible), providing documents in an alternate format, using a sign language interpreter, or using specialized equipment.

To be provided a Reasonable Accommodation during the hiring process, you will need to provide a certification of disability from a physician, psychiatrist, school official or an Illinois Department of Human Services (DHS) Division of Rehabilitation Services (DRS) Vocational Rehabilitation (VR) Counselor. Supporting documentation should be uploaded under My Documents → Additional Documents section for each application.

Any questions on Reasonable Accommodations can be directed to Central Management Services Disability Resource Center at CMS.DisabilityResCen@illinois.gov or call (217) 524-7514 for further information and to request or discuss an accommodation.

Sponsorship for Employment

The State of Illinois does not provide sponsorship for employment visa status (e.g. H-1B visa status). To be considered for permanent employment with the State of Illinois, applicants must be currently authorized to work in the United States on a full-time basis.

Disclosure of Salary Information

In compliance with the Illinois Equal Pay Act, 820 ILCS 112/1 et seq., the State does not seek, request, or require a job applicant’s wage or salary history.  Employment decisions are not made based on an applicant’s wage or salary history.  To that end, please do not include wage or salary information in your resume or other profile or application materials.

Date:  Jan 23, 2023
Location: 

Springfield, IL, US, 62701-1634

Job Requisition ID:  22968

Agency :  Department of Healthcare and Family Services 
Position ID: MP22968

BPIS: 10454
Group: CL (B-H)

Start Date: 01/24/2023

Closing Date: 02/06/2023 
Salary:   $5,246 - $7,827 Anticipated start salary for non-state $5,246  
Job Type:   Salaried Full Time  
County:   Sangamon  
Number of Vacancies:   1  
Plan/BU:   RC062  

 

This position is a union position; therefore, provisions of the relevant collective bargaining agreement/labor contract apply to the filling of this position.

 

All applicants who want to be considered for this position MUST apply electronically through the illinois.jobs2web.com website.

If you are seeking a Transfer: Please remember to upload a State of Illinois Department of Central Management Services Illinois Federation of Public Employees (IFPE) - Transfer Request Form. State of Illinois employees should click the link near the top left to apply through the SuccessFactors employee career portal.

Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered.

 

Posting Identification Number  MP22968

Job Description:

The Department of Healthcare and Family Services (HFS), Division of Medical Programs’, Bureau of Professional and Ancillary Services is seeking a motivated individual with medical knowledge and strong customer service skills for the position of Medical Assistant Consultant III in the Prior Approvals Waiver Unit. The candidate will conduct complex and specialized reviews of Durable Medical Equipment (DME)/Optical and Pharmacy services submitted by providers. It is imperative that the successful candidate possess organizational skills, leadership attributes and personify human relations skills to work with an array of individuals, partners including elected officials. The ideal candidate will be detail oriented, a good communicator and have knowledge and experience in the fields of medical care or rehabilitation assistance.

 

HFS values employees with different backgrounds, life experiences, and talents.

 

Employees receive a robust benefit package including:

  • Monday-Friday work schedule
  • Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)
  • Health, Life, Vision, and Dental Insurance
  • Pension Plan
  • (10) Weeks paid Maternity/Paternity Leave
  • Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
  • Employees earn (12) paid Sick Days annually.
  • New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.
  • Employees earn (3) paid Personal Days annually.
  • (13-14) paid holidays annually (based on start date) 

If you are seeking a new opportunity, and this position appeals to you, please apply today!

 

At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained.

 

HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion.  We welcome and value employees with different backgrounds, life experiences, and talents.  It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement.  In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer.

Job Responsibilities

  • Conducts highly complex and specialized reviews of Durable Medical Equipment (DME)/Optical and Pharmacy medical services requiring prior approval submitted by providers for care and services extended to medical assistance recipients prior to services being rendered
  • Applies professional training and experience in the field of nursing to review and interpret medical treatment, medical equipment, pharmaceuticals, and billings to ensure medical procedures, services and equipment are appropriate and meet State/Federal guidelines
  • Reviews, researches and analyzes medical program correspondence/material to develop protocols for coverage
  • Responds to telephone inquiries or correspondence from providers, legislators, other state agencies and the medical community regarding Medicaid policies and procedures relating to the collection of medical information
  • Participates in research studies of specialized medical care and or equipment, pharmaceuticals, and rehabilitation programs, relative to services of provider costs versus current reimbursement rates
  • Confers with Medical Providers, Physicians, Hospital Discharge Planners and interested parties concerning medical necessity for requested item/services
  • Serves as backup in the review of prior approval requests for other medical equipment/supplies and home health needs
  • Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above

 

Minimum Qualifications

  • Requires knowledge, skill and mental development equivalent to completion of four years of college with licensure in one of the following specialties: Registered Nurse, Licensed Practical Nurse, Speech/Language Pathologist, Respiratory Therapist, Physical Therapist or Occupational Therapist
  • Requires three years professional experience in field related to medical (mental and physical) treatment and care

Preferred Qualifications

  • Two (2) years of experience in medical treatment casework
  • Two (2) years of experience and knowledge of federal, state, or local legislation involving public instruction related to public assistance, medical care, or rehabilitation assistance
  • One (1) year of experience giving consultation or instructions related to professional medical services
  • One (1) year of experience composing, reviewing, analyzing, and revising material of an instructional, procedural, or interpretive material
  • One (1) year of experience establishing satisfactory working relationships with local government officials, local staffs, recipient’s medical/rehabilitation providers, and the public.

Conditions of Employment

  • Requires the ability to pass a background check
  • Requires the ability to travel
  • Requires the ability to maintain State issued equipment such as a laptop

Work Hours:  8:30 a.m. - 5:00 p.m. Monday - Friday  
Work Location: 607 E Adams St Springfield, IL 62701-1634  
Agency Contact:
 
HFS.DMPApps@illinois.gov

Job Family:  Health Services  

 

This position DOES NOT contain “Specialized Skills” (as that term is used in CBAs).

 

APPLICATION INSTRUCTIONS

Use the “Apply” button at the top right or bottom right of this posting to begin the application process.

If you are not already signed in, you will be prompted to do so. 

State employees should sign in to the career portal for State of Illinois employees – a link is available at the top left of the Illinois.jobs2web.com homepage in the blue ribbon. 

If you are seeking a Transfer: Please remember to upload a State of Illinois Department of Central Management Services Illinois Federation of Public Employees (IFPE) - Transfer Request Form.

Non-State employees should log in on the using the “View Profile” link in the top right of the Illinois.jobs2web.com homepage in the blue ribbon.  If you have never before signed in, you will be prompted to create an account.

If you have questions about how to apply, please see the following resources:

State employees: Log in to the career portal for State employees and review the Internal Candidate Application Job Aid

Non-State employees: on Illinois.jobs2web.com – click “Application Procedures” in the footer of every page of the website.

 

The main form of communication will be through email. Please check your “junk mail”, “spam”, or “other” folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses:

  • donotreply@SIL-P1.ns2cloud.com
  • systems@SIL-P1.ns2cloud.com