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PROGRAM ANALYST - (SPSA, Opt. 3) PSC

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

Persons with disabilities are provided reasonable accommodations throughout the hiring process and during performance of all job duties.  Please email the Central Management Services Disability Resource Center at CMS.DisabilityResCen@illinois.gov or call (217) 524 - 7514 for further information and to request 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:  Sep 14, 2021
Location: 

Springfield, IL, US, 62702-3406

Job Requisition ID:  2969

Agency:  Department of Healthcare and Family Services 
Closing Date/Time:  09/28/2021 
Salary:  Dependent upon qualifications 
Job Type:  Salaried Full Time 
County:  Sangamon 
Number of Vacancies:  1 
Plan/BU:   

 

*** THIS IS A PERSONAL SERVICES CONTRACT ***

 

ABOUT THE POSITION:

The Department of Healthcare and Family Services, Bureau of Medicaid Management Information Systems’ is seeking a high energy individual with experience working with the Medicaid Management Information System (MMIS), Illinois Michigan Program Alliance for Core Technology (IMPACT) system, Integrated Eligibility  System (IES), and Managed Care Organization (MCO) Expansion to serve as a Program Analyst.  The ideal candidate will demonstrate the ability to work cohesively with internal and external partners to develop and analyze best practices to evaluate each project’s requirement as they relate to managed care, assess impacts to the existing claims processing systems and the supporting operational databases which house the Department’s providers, payee and recipient databases.  The ideal candidate will exhibit strong leadership skills to achieve set goals while demonstrating independent initiative.  The candidate will possess strong communication skills.

 

****************A RESUME IS REQUIRED FOR THIS JOB POSTING****************

Please attach a DETAILED Resume/Curriculum Vitae (CV) to the MY DOCUMENTS section of your application. You WILL NOT be considered for the position if you attach a CMS100, CMS100b or any other document that is not a Resume or CV.

Job Responsibilities

  1. Serve as subject matter expert for the Bureau of Medicaid Management Information Systems, IL Department of Healthcare and Family Services; evaluate the managed care organization capitation operations as they pertain to the implementation of Illinois Michigan Program Alliance for Core Technology (IMPACT), Integrated Eligibility System (IES) and Managed Care Organization (MCO) Expansion projects.
  2. Make independent assessment and recommendations for functional and operational changes as deemed necessary that meet X12 EDI (Electronic Data Interchange), HIPAA (Health Insurance Portability and Accountability Act) and Medicaid rules and statutes
  3. Plans, develops, and implements processes and procedures to effectively implement managed care data processing changes to the Recipient-Provider-Reference (RPR) subsystem of the current Medicaid Management Information System (MMIS) in the Department of Healthcare and Family Services.
  4. Advise senior managers of HFS, MMIS Bureau Chief and Assistant Bureau Chief on the functions of the legacy process and provide assistance and guidance on the implementation of new system requirements for these projects as they relate to managed care expansion. 
  5. Evaluate the features of the existing system and the gaps between the current legacy system and project requirements for IMPACT, IES and MCO Expansion projects.  Review business rules, assess systems applications and functions, perform impact analysis and estimates for time to complete.  Participate in and review the results of testing and simulation.
  6. Serve as liaison between the Division of Information Systems and Division of Medical Programs for project coordination, work item backlog management, and problem root cause analysis and resolution as they pertain to the Illinois Michigan Program Alliance for Core Technology (IMPACT), Integrated Eligibility System (IES) and Managed Care Organization (MCO) Expansion.

Minimum Qualifications

  1. Requires knowledge, skill and mental development equivalent to the completion of four years of college. 
  2. Requires prior experience in technical application development in a public or business organization managing a Medicaid Program and/or medical claims adjudication with specialization in managed care claims processing, managed care enrollments and dis-enrollments.   
  3. Requires prior experience with information systems technologies:  IBM mainframe Z/OS development environment , COBOL, Job Control Language (JCL), IBM Database 2 (DB2), IBM Information Management System/Database (IMS DB), Virtual Storage Access Method (VSAM) file utilization, Structured Query Language (SQL), project management methodology, Mainframe Express (MFE), X12 EDI Standards for 834 and 820 transactions, and the Health Insurance Portability and Accountability Act (HIPAA) as it relates to managed care organizations.  
  4. Requires at least three (3) experience with the MMIS Managed Care Organization Capitation system and its interactions with other HFS MMIS systems and subsystems.

Preferred Qualifications

  1. Coursework in college or trade school for information technologies such as COBOL, IBM Mainframe Z/OS, Job Control Language (JCL), project methodology, Virtual Storage Access Method (VSAM), Information Management System Database (IMS DB), IBM Database 2 (DB2), and Structure Query Language (SQL). 
  2. Requires at least three (3) years of experience of the Department’s Managed Care Organization Capitation system and its interactions with other HFS MMIS systems and subsystems and processing of the MCO Intake file. 
  3. Requires at least three (3) years of HIPAA X12 834 and 820 transactions experience is paramount to optimizing timely and successful project outcomes for the IMPACT, IES and MCO Expansion projects. 
  4. Detailed knowledge and experience with terminologies and what they mean for managed care information systems processing:  Enrollment, Dis-enrollment, Anniversary Date, Voluntary, Mandatory, Lock-in Period, Re-instatement, and Capitation.

Conditions of Employment

  1. Requires the ability to pass a background check.
  2. Ability to work normal working hours.

Work Hours:  8:30 a.m. - 5:00 p.m. Monday - Friday 
Work Location: 2200 Churchill Rd Springfield, IL 62702-3406 
Agency Contact:  HFS.DOITApps@illinois.gov
Job Function: Administration/Management 

 

ABOUT THE AGENCY/BUREAU/PROGRAM

At the Illinois Department of Healthcare and Family Services (HFS), we work in a spirit of teamwork to help millions of people in Illinois lead healthier and more successful lives.  We provide healthcare coverage for child 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.  HFS is an equal opportunity employer.

HFS is committed to promoting and preserving a workplace culture that embraces diversity 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.