The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needs. DMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services and supports that protect and promote the health and well-being of all Kentuckians and their communities.
The Division of Quality and Population Health’s mission is to ensure that all Kentuckians receive access to and are knowledgeable about the full benefits offered through the program. We are currently participating in an innovative multi-state project to identify methods that will address the unique needs related to the social determinants of health (SDoH) for minority populations.
The Human Services Program Compliance Analyst will work closely with the Branch manager and the leadership team to provide programmatic support and guidance for contracted managed care organizations (MCOs) providing quality assurance and compliance support for the branch. If you are innovative, possess highly developed organizational skills, and have a drive for achieving health equity for ALL Kentuckians, come join our team!
Learn more about us at:
https://chfs.ky.gov/agencies/dms/Pages/default.aspx
Responsibilities and duties included but not limited to:
- Interprets and provides feedback regarding compliance related to regulations, policies, processes, and procedures with contracting agencies as it relates to social determinants of health and screening requirements for Medicaid enrollees.
- Develops dashboard progress reports and reviews the same to identify focus areas related to equity and social determinants of health (SDoH) for Medicaid enrollees.
- Implements, develops, and evaluates quality assurance plans with contracted MCOs to meet and achieve established goals and outcomes.
- Serves as liaison for Managed Care Organizations (MCOs) and department staff work groups. Collaborates with MCO representatives to address identified challenges within the specific region or district preventing goal attainment.
- Represents the branch by attending advisory groups and MCO operations meetings.
- Provides presentations including reporting of branch outcomes to interested stakeholders, partners, or potential partners as needed.
- Performs other duties as assigned.
Preferred Knowledge/Skills:
- Analytical skills
- Assessment and planning skills
- Knowledge of quality assurance measures
- Keen attention to detail
- Time management skills
- Communication and presentation skills
- Teamwork and flexibility
The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9. For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https://www.e-verify.gov/.