Medicaid Operations Coordinator
Cerritos, CA 
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Posted 14 days ago
Job Description
Medicaid Operations Coordinator

Job Location
Remote

Position Type
Full-Time/Regular

Qlarant is a not-for-profit corporation that partners with public and private sectors to create high quality, safe, and efficient delivery of health care and human services programs. We have multiple lines of business including population health, utilization review, managed care organization quality review, and quality assurance for programs serving individuals with developmental disabilities. Qlarant is also a national leader in fighting fraud, waste and abuse for large organizations across the country. In addition, our Foundation provides grant opportunities to those with programs for under-served communities.


Are you an experienced administrative assistant recognized for your attention to detail, organizational skills and ability to effectively communicate with a wide range of people? Do you have exceptional technical abilities to include proficiency in Microsoft Office and related applications? Do you approach your work with a sense of urgency and a desire to see it through to a timely completion? If yes, we've got the perfect opportunity for you! As an Operations Coordinator at Qlarant, you will be specific to the Medicaid team with an emphasis on Medicaid appeals and coordination. This position can be considered in our Dallas, TX office, Easton, MD office, or potentially remote for the right candidate.

The Operations Coordinator's duties and responsibilities include the following. Other duties may be assigned.

  • Liaison to CMS and other governmental entities to obtain/provide information, identify issues and assists with timely responses to inquiries regarding contract.
  • Responds to client inquiries via written or oral communications.
  • Ensures contract compliance by monitoring deliverables, contract requirements, and communicating Medicare change requests.
  • Works with other business units to ensure the effective coordination of objectives/deliverables, establish permissions in systems, perform quality review of deliverables to ensure compliance in accordance with applicable regulations within the scope of work, managing activities, and facilitating project by setting priorities.
  • Coordinate and manage the transition of workloads, and serve as the interface with other entities.
  • Contractor Administrator for CMSARTs system.
  • Writes reports, prepares presentations, and ensures the timely approval by Program Director of deliverables.
  • Provides training and technical advice to team members.
  • Coordinates new CMS User ID set ups and background verifications.
  • Works with Quality Director/Officer on ISO initiatives to improve operational systems, processes and policies to improve information flow, management reporting, business process and organizational planning.
  • Facilitates project logistics such as meetings, conference rooms, conference calls, etc.
  • Participates and/or leads internal/external committees as assigned.
  • Coordinates with internal staff and external partners regarding Medicaid appeals

Required Skills

To perform the job successfully, an individual should demonstrate the following competencies:

Problem Solving - Identifies and resolves problems in a timely manner.

Customer Service - Responds promptly to customer needs; Responds to requests for service and assistance.

Judgment - Displays willingness to make decisions; Exhibits sound and accurate judgment; Includes appropriate people in decision-making process.

Planning/Organizing - Prioritizes and plans work activities; Organizes or schedules other people and their tasks.

Computer Skills - Intermediate proficiency with Microsoft Office to include Excel, Access, PowerPoint, Word and Outlook.


Required Experience

Education and/or Experience:

* High school diploma or GED required, Associates Degree in business preferred.
* At least 1 year of experience in an intermediate-level administrative position; or an equivalent combination of education and experience.
* Prior experience working with medical records strongly preferred.
* Prior experience working on government contracts strongly preferred.
* Intermediate proficiency with Microsoft Office to include Excel, Access, PowerPoint, Word and Outlook.
* Working knowledge of Medicare and/or Medicaid protocols for Fraud and Abuse investigations is preferred.
* Experience working with customer requirements and coordinating reports and deliverables.

Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities.


Qlarant is an Equal Opportunity Employer of Minorities, Females, Protected Veterans, Sexual Orientation, Gender Identity, and Individuals with Disabilities. Best People, Best Solutions, Best Results

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
High School or Equivalent
Required Experience
1+ years
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