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Coding Initiatives & MMIS Manager

Date Posted:  Jan 14, 2022
Requisition ID:  216901
Location: 

Indianapolis, IN, US, 46204

 

Work for Indiana

Grow your career with the State of Indiana! With more than 50 executive branch agencies, the State of Indiana is a diverse workforce offering employees stimulating and challenging projects across a broad scope of career opportunities. As a State of Indiana employee, you impact the well-being of Indiana’s communities every day.

 

At the State of Indiana, we don’t just talk about diversity and inclusion – Our goal is to create a welcoming, accessible, and equitable workplace, with a workforce that is representative of the State of Indiana population. We are proud to be an equal opportunity employer.

 

About the Family & Social Services Administration: 

The Office of Medicaid Policy and Planning (OMPP) is a division within the Family and Social Services Administration, which receives around 13 percent of the state's budget to ensure vital health care coverage to approximately 1 in 5 Hoosiers. OMPP strives to build programs and processes that enable Hoosiers to live in fully engaged communities and reach their greatest emotional, mental and physical well-being. Our mission is to support individual and community well-being with effective and efficient programs, remarkable collaborations, measurable impact on individuals and communities, and an energized staff that is fully engaged with this mission. 

 

Salary:   The annual minimum starting salary for this position is $ 50.518.00.   

About the Job:

The purpose of this position is to oversee the Coding Initiatives and Medicaid Management Information System (MMIS) team with a primary focus on the alignment of the Medicaid claims payment system with Medicaid Program requirements.

A Day in the Life:

The essential functions of this roles are as follows:

  • Provide leadership, day-to-day supervision, and development opportunities to the Coding Initiatives and MMIS reimbursement team; provide guidance for staff regarding project development and
  • implementation.
  • Monitor and manage work of the claims processing vendor, maintain accountability, and
  • ensure contractor performs in accordance with agency goals; Ensure claim systems is compliant with current federal and state policies. 
  • Serve as key subject matter expert in claim processing, managing claim inquiries and appeal questions, provider services inquiries, and serve as the claims technical lead in system change implementation.
  • Apply clinical and/or medical coding perspective to program implementation and data for Indiana Medicaid programs. Communicate complex information to staff, contractors, agency administrators, and others within expected guidelines and established time frames
  • Conduct research on and monitor medical coverage status, billing, and reimbursement methodologies employed by commercial plans, Medicare and other state Medicaid agencies to identify "best practices" for consideration by the agency; work with Section Director to implement training/knowledge sharing of activities
  • Oversee the quarterly and annual International Classification of Disease (ICD) and Healthcare Common Procedure Coding System (HCPCS) codes determination process and ensure the system is updated timely and appropriate stakeholders are engaged.
  • Support data and reporting needs by acting as a liaison between OMPP, Data and Analytics, and FSSA Finance
  • Assist and own other projects in support of the agency’s mission as assigned by supervisor,
  • division executives, and agency leadership.

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.

What You'll Need for Success:

Bachelor's degree in a healthcare-related field, policy analysis, public administration or similar plus at least 3 years healthcare experience required. Masters or Graduate Degree preferred.  Experience in Medical Coding is a plus.

  • Working knowledge of claims processing systems and ability to accurately interpret complex technical materials and claim adjudication logic
  • Strong leadership and creative problem-solving skills; must possess excellent verbal and written communication skills and the ability to effectively engage stakeholders ranging from members of the public to agency leadership or health plan executives.
  • Knowledge of federal and state public health care programs and policy, healthcare purchasing, the health insurance industry, and national public health care issues and trends. Must be familiar with Medicaid delivery systems and underlying programs.  Familiarity with Indiana Health Coverage Programs (IHCP), preferred.
  • Ability to plan, initiate, and properly execute programs and initiatives.  Must be highly self-motivated, analytically-minded, and possess initiative. and able to manage multiple projects simultaneously
  • Passion for public service

Supervisory Responsibilities/Direct Reports:

This role provides direct supervision for one or more staff members.

What You’ll Get in Return: 

The State of Indiana offers a comprehensive benefit package for full-time employees which includes: 

  • Three (3) medical plan options (including RX coverage) and vision/dental coverages 
  • Wellness program (offers premiums discount for the medical plan) 
  • Health savings account (includes bi-weekly state contribution) 
  • Deferred compensation account (similar to 401k plan) with employer match 
  • Two (2) fully-funded pension plan options 
  • Group life insurance 
  • Employee assistance program that allows for covered behavioral health visits 
  • Paid vacation, personal and sick time off 
  • Competitive leave policies covering a variety of employee needs 
  • 12 company paid holidays, 14 on election years 
  • Qualified employer for the Public Service Loan Forgiveness Program 
  • New Parent Leave 
  • Free Parking 
  • Free LinkedIn Learning 

 

Equal Employment Opportunity:

The State of Indiana is an Equal Opportunity Employer.

 

Current Employee? Click here to apply.


Nearest Major Market: Indianapolis