Program Integrity Specialist - MEQC

Job Description

Job Description

Program Integrity Specialist - MEQC

Location : New Castle

Schedule : Monday through Friday

Pay Rate : $21.00

In this role, you will be responsible for reviewing a sample of Medicaid case files, identifying any errors or issues with the eligibility determination process, and recommending corrective actions to improve program integrity. You will work closely with our Medicaid administration team to ensure that our citizens receive the care and support they need, while also maintaining the highest standards of compliance and accountability.

Key Responsibilities :

• Conduct comprehensive reviews of Medicaid case files to verify the accuracy of eligibility determinations
• Identify and document any errors or discrepancies in the eligibility determination process
• Analyze data and trends to pinpoint areas for improvement in Medicaid program integrity
• Collaborate with Medicaid administrators to develop and implement corrective action plans
• Maintain detailed records and prepare reports on the findings of your case reviews

Qualifications :

Our agency is an equal opportunity employer, committed to fostering a diverse and inclusive workplace.

If you are passionate about ensuring the integrity of critical public health and social services programs, we encourage you to apply for this exciting opportunity.