The Oregon Health Authority (OHA) is a state agency dedicated to helping people and communities achieve optimum physical, mental and social well-being through partnerships, prevention and access to quality, affordable health care. We are absolutely committed to ongoing innovation in the delivery of services, and to recruiting, developing and retaining dedicated employees.
OHA includes most of the state's health care programs, including Public Health, Health Policy and Analytics, Health Systems Division, and Oregon State Hospital. Incorporating the state's health care programs within one agency gives the state greater purchasing and marketing power to begin tackling the issues of cost, quality, and access to care.
This employment opportunity is with the Office of Information Service – Shared Services, under the Oregon Health Authority (OHA). There is one full-time, permanent position located in Salem (500 Summer Street NE). This position is classified as management service, supervisory and is not represented by a union.
DUTIES & RESPONSIBILITIES:
The purpose of this position is to provide management-level supervision and leadership to ensure Medicaid program integrity responsibilities of OHA as the Single State Medicaid Agency. Responsibilities will include ensuring that oversite, monitoring, audits and reviews are scheduled and completed and that corrective actions are in place and followed through within partner agencies and programs. This position will ensure the coordination and compliance with Medicaid funded operations in partner state and local agencies. This role will serve as the key point of contact for OHA regarding Medicaid operations within other state and local agencies such as DHS and county-based programs. The person in this position will lead in the prevention, detection, identification and investigation of fraud, waste and abuse in the $6 billion dollar per year Oregon Medicaid Program.
Six years of experience in supervision, staff-technical, or professional-level work. Two years of this experience must have included supervision and management of a program, section, or unit which included:
a) Development of program rules and policies,
b) Development of long- and short-range goals and plans,
c) Program evaluation, and
d) Budget preparation.
(NOTE: A Bachelor's degree or equivalent course work (144 quarter or 96 semester hours) in a field related to management, such as Business, Public Administration or a similar field, may be substituted for three years of the required experience, but will not substitute for the two years of specialized experience.)
• Three or more years of experience with auditing or program performance reviews.
• Bachelor's degree in healthcare, business, accounting, auditing or a related field.
• Strong working knowledge of Medicaid Program Integrity operations and requirements as well as the prevention, detection, identification and investigations of fraud, waste and abuse.
• Experience using data analytics applications in the prevention, detection, identification and investigation of fraud, waste and abuse.
• Knowledge of program integrity theory and application.
• Excellent customer service and communication skills to deal with differing opinions related to program integrity, oversight and monitoring.
• Ability to interpret complex regulatory principles.
• Experience in promoting a culturally competent and diverse work environment.
Please follow the link below to submit an application.