Medicare & Buy-In Policy Analyst 2025-02123

Open Until Filled

GENERAL DESCRIPTION

The Wyoming Department of Health, Division of Healthcare Financing, is seeking applicants for the position of Medicare and Buy-In Program Analyst. This position is responsible for the management and administration of the Medicare Buy-In and Medicare Savings Programs, and the coordination of benefits related to Medicare.

RESPONSIBILITIES

• Develop policy, state plans, rules, and regulations based on federal and state laws through research, analysis, design, implementation, and evaluation for current and proposed programs, and coordinate the rules and policy adoption process to ensure compliance.
• Coordinate and maintain policy manual related to Medicare Savings Programs, dual eligibility, and Medicare Buy-In.
• Develop educational and outreach materials for the public as well as internal and external divisions and agencies.
• Determine data collection requirements and needs, and analyze data.
• Understand and monitor program budgets and recommend funding decisions and program operation policies and procedures by tracking premiums paid and costs avoided by ensuring Medicare is the primary payer.
• Program planning and development of long and short-range changes to the Medicare Savings Programs and the effect the changes will have on the Wyoming Medicaid Program.
• Coordinate with the Social Security Administration, Wyoming State Health Insurance Information Program (WSHIIP), Medicaid Fiscal Agent, and other agencies to ensure quality initiatives are being met for Medicare and Medicaid dual eligibility.
• Research potential program options to improve access.
• Program Reporting and Analysis related to the Medicare Savings Programs, Crossover Claims, Medicare Parts C & D, and Medicare and Medicaid Dual Eligible, Medicare Coverage Benefits and Rates.
• Assist in coordination between other agencies and units, including other sections within the Department of Health.
• Review and resolve Buy-In tasks from the Center for Medicare and Medicaid Services (CMS) daily.
• Review monthly Buy In invoice reports for accuracy, make updates as necessary to Buy-In categories, and approve the Buy-In invoices for payment.
• Oversee the D-SNP contract and monthly reporting.
• Review monthly reports in the Client Services Unit to identify errors, correct cases, and report on patterns.
• Other duties as assigned.

PREFERENCES

Preference will be given to individuals with experience with Medicare and Medicaid eligibility programs.

KNOWLEDGE

MINIMUM QUALIFICATIONS

Education : Bachelor's Degree

Experience : 0-3 years of progressive work experience (typically in Benefits and Eligibility) with acquired knowledge at the level of a Senior Benefits and Eligibility Specialist

OR

Education & Experience Substitution : 4-6 years of progressive work experience (typically in Benefits and Eligibility) with acquired knowledge at the level of a Senior Benefits and Eligibility Specialist

Certificates, Licenses, Registrations

None

PHYSICAL WORKING CONDITIONS

NOTES

The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.

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