Job Description

Posting number: 27-01032

Department: 400 Health & Human Services - Medicaid

Job classification: Procurement Specialist 4

Posting type: Open

Categories: Accounting and Finance, Human Services, Business, Program Management

Summary

The Iowa Department of Health and Human Services (HHS), Iowa Medicaid Division, is seeking three candidates for three Medicaid Contract Manager (Procurement Specialist 4) positions. Medicaid is a State-federal funded program administered by the Iowa Department of Health and Human Services and is the second largest insurance program in the State of Iowa. Be part of an organization that is continually working to modernize and innovate solutions to improve the quality of life and health outcomes for the State’s Medicaid members.

Iowa Medicaid Contract Managers provide the requisite oversight of agreements between the Agency and private contractors for all assigned contracts in support of the administration of the Medicaid Program. Contract Managers participate in initial request for proposal (RFP) processes, the negotiation, development, and execution of contracts, and provide direct contract oversight of vendors to ensure Contractor compliance with contract deliverables, and State and federal regulations, which includes requirements outlined in the various Centers for Medicare and Medicaid (CMS) planning documents.

The position plays a key role in ensuring Contractor performance measures are met that ensure Program efficiencies, minimize or avoid duplication of efforts, and support Medicaid strategic goals. The successful candidate will serve as a key advisor to executive leadership on assigned contracts, will coordinate with program subject matter experts (SMEs), and will make day-to-day decisions to assure Contractors are contractually compliant and consistently providing reliable services to support the Medicaid Program, members, providers, and stakeholders.

The Medicaid Contract Manager is a liaison between Contractors and the Agency, serving as the point of contact for coordinating communications related to performance monitoring, risk, and dispute management and will also interact with sister agencies, including but not limited to, CMS regulators.

Tasks include:

• Contract management and oversight of assigned Medicaid contracts.
• Assuring that Contractors are compliant in all aspects of their contract in order to ensure the Agency consistently provides reliable services to Iowa's members and providers so positive health outcomes are achieved; providers are supported; fraud and abuse is minimized; and State payments to Contractors are justified.
• Assist in the Agency coordination, review, and approval of Contractors’ standard operational procedures, implementation plans, communications, and other required documentation to ensure contractual compliance.
• Conduct and facilitate formal monthly Contractor oversight/operations meetings and develop communication and contract tracking tools for deliverables.
• Determine Contractor compliance with contractual requirements to assure contract deliverables and performance measures are met in alignment with the Medicaid strategic plan.
• When there is Contractor failure to comply or deficiencies found, initiate corrective action plans (CAPs) or termination in collaboration with the Medicaid Director.
• Prepare reports as requested summarizing Contractor progress and compliance for variance audiences such Medicaid leadership, the Governor's office, the Legislature CMS, stakeholders, and the public.
• Serve as an advisor to the Medicaid leadership team and the Medicaid Director to assist in confidential decision-making pertaining to contractual compliance; development of aligned strategies to improve care and services; and the modification of Agency policies and procedures.
• Identify complex and sensitive problems and review related information to develop and evaluate options and implement solutions via coordination with Program SMEs as policies and procedures are drafted and best practice is defined.
• Lead the development of requests for information (RFIs), requests for proposals (RFPs), and associated materials to implement Medicaid service and system procurement priorities as identified in the federally approved Advanced Planning Document (APD).
• Lead development of vendor contracts and contract negotiations to assure State needs are effectively represented. Contract negotiations require significant understanding of programmatic, budgetary, and federal and State requirements.
• Facilitate and/or participate in the procurement process for Medicaid including but not limited to requests for information (RFIs), request for proposals (RFPs); writing RFPs, and leading evaluation committees, as needed.

To ensure Iowa Medicaid provides the best services to the citizens of Iowa, applicants should demonstrate exceptional customer service skills, integrity, and a strong work ethic, along with the skill set below.

Successful candidates will:

• Have demonstrated, self-directed, proven contract and project management skills designed for complex and large scale initiatives.
• Have the ability to comprehend and apply State and federal regulations pertaining to the Medicaid Program.
• Understand and interpret State and federal process requirements pertaining to the Medicaid Program, funding, and contracts.
• Be detail-oriented and able to handle multiple tasks efficiently and effectively.
• Communicate effectively through a variety of mediums with internal and external audiences to inform and continually foster productive relationships.
• Have proven PC skills including Windows and Microsoft Applications.

Benefits

Working for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a comprehensive benefits package designed to support your well-being and professional growth:

• Health, Dental, and Vision Coverage: Health and dental insurance packages to keep you and your family healthy at a low cost with outstanding coverage!
• Paid Time Off: Take time to recharge with paid time off, including vacation (96 hours/year to begin, increasing with years of service), sick leave (144 hours/year), and paid holidays (9 days/year).
• Retirement Plans: Participate in retirement plans such as IPERS (employees contribute 6.29% and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC), Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to $75/month).
• Flexible Spending Accounts: Take advantage of flexible spending accounts for medical and dependent care expenses.
• Insurance Coverage: Benefit from life insurance and free long-term disability insurance for added peace of mind.
• Employee Assistance Program: Access resources and support through our Employee Assistance Program for personal and professional challenges.
• Employee Discount Programs: Enjoy discounts on a variety of goods and services through our employee discount programs.

For additional information on benefits click here.

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Background Checks

Applicants will be required to complete a background check to be considered for this position.

The State of Iowa is an EEO/AA Employer

HHS values those with “lived experience” and encourages adults who were fostered as youth, foster parents, and/or parents who were in the DHS system to apply. Minorities, women, persons with disabilities and veterans are encouraged to apply (Hearing and Speech Impaired – Relay Iowa 1-800-735-2942 TDD).

E-Verify and Right to Work

The State of Iowa participates in E-Verify, a federal program that helps employers confirm the employment eligibility of all newly hired employees. Within the required timeframe, new hires will be verified through the E-Verify system to ensure authorization to work in the United States. The State of Iowa also complies with the federal Right to Work laws, which protect employees’ rights to work without being required to join a labor organization. For more information, please visit www.e-verify.gov.

All work performed on behalf of Iowa Health and Human Services must occur in the State of Iowa.

Qualifications

Applicants must meet at least one of the following minimum requirements to qualify for positions in this job classification:

1.) Eight years of full-time work experience in the procurement of technical, standardized, expendable, and non-expendable items, or in services procurement and contract administration, including the review of ongoing compliance with contract requirements and terms.

2) Graduation from an accredited four-year college or university with a degree in business or public administration, accounting, or economics, and experience equal to four years of full-time work in the procurement of technical, standardized, expendable and non-expendable items or in services procurement and contract administration, including the review of ongoing compliance with contract requirements and terms. Procurement Specialist 4 Class Code: 00213 4

3) A total of eight years of education and/or full-time experience (as described in number one), where thirty semester hours of accredited college or university coursework in any field equals one year of full-time experience.

4) All of the following (a, b, and c): a. Three years of full-time work experience in the procurement of technical, standardized, expendable, and non-expendable items, or in services procurement and contract administration, including the review of ongoing compliance with contract requirements and terms; and b. A total of four years of education and/or full-time experience (as described in part a), where thirty semester hours of accredited college or university coursework in business or public administration, accounting, or economics equals one year of full-time experience; and c. A total of one year of graduate-level education and/or full-time experience (as described in part a), where twenty-four semester hours of accredited graduate college or university coursework in business or public administration, accounting, or economics equals one year of full-time experience.

5) Current, continuous experience in the state executive branch that includes one year of full-time work as a Procurement Specialist 3.

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