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  • program integrity – coordinator 1
View All Listings

Program Integrity – Coordinator 1

Status: Full-time

Department: Medicaid Services Contract – Program Integrity

Posted: Wednesday, March 25, 2020

Salary: Commensurate with qualifications and experience.

Job ID: 9989, 9986, 9966, 9961, 9960


Important Notice

The University of New Orleans is an Affirmative Action / Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local laws.
NOTE: If a diversity statement is listed as one of the required documents to apply for a position, please click here for instructions.

Position Summary

5 positions located in Baton Rouge

Responsibilities
  • Investigate providers of various Medicaid programs to ensure expenditures are made in accordance with Federal and State regulations.
  • Process and track all Medicaid provider and recipient related complaints reported via email, the Medicaid Fraud website or internally.
  • Interacts with varies internal and external entities such as Medicaid recipients, Medicaid providers, LDH program operations, licensing boards, the Attorney General’s office, etc.
  • Document findings of investigations initiated by referrals from Medicaid programs including but not limited to OAAS, Behavioral Health, Provider Enrollment, MFCU and Plans.
  • Detail any corrective action(s) necessary after conducting a comprehensive case review of findings.
  • Ensure all providers are furnished with a written notification of any corrective actions and cite the applicable Medicaid/LaCHIP policy reference.
  • Assist in maintaining records of provider fraud, waste and abuse referrals for investigation.
  • Maintain findings and results on fraud referrals received within the centralized tracking system.
  • Conducts research on all policy violations and corrective action.
  • Maintains and assists with up-to-date reporting statistics and data for unit reports.
  • Notify management of any trends that are a direct cause of or contributing factor to errors that come to light during the review process or while tracking all cases received for review.
  • Refer applicable cases to the Office of the Attorney General.
  • Prepare written summary report with all relevant background facts.
  • Provide any assistance needed to the legal authority.
  • May be called upon as a witness to a case once it proceeds to trial.
  • Complete special projects as directed by management.
Required Qualifications
  • Bachelor's degree or 6 years of professional experience in lieu of degree.
  • Excellent analytical skills, effective organizational and time management skills.
  • Excellent verbal and written communications skills.
  • Proficient in the use of Microsoft Office, including but not limited to Outlook, Word, and Excel.
Desired Qualifications
  • Advanced degree.
  • 2 years professional experience in provider enrollment and credentialing.
  • 1 year professional experience with Louisiana Medicaid policy and procedures.
  • Experience with Electronic Visit Verification.
  • Experience with data analysis and report development.
Closing Date

Position will remain open until filled.

How to Apply

In order to proceed, please provide the following information about yourself to help UNO comply with federal regulations about equal employment opportunity. This information will be used only for statistical purposes.

We ask you to provide the information below about yourself in order to help UNO comply with federal regulations about equal employment opportunity.

This information is confidential and will be used only for statistical purposes. This information will not affect your employment opportunities with UNO.

*All fields are required. If you do not wish to answer a question, select the option, "I prefer not to answer."

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