Benefit Program Supervisor 3.20.25

The MO Medicaid Audit & Compliance Unit (MMAC) has an opening for a Benefit Program Supervisor within the Provider Review and Lock-In Unit located in Cole County.

Job Posting Number: 4016 8260001

Semi-monthly salary: $2525.51

Annual salary: $60,612.24

Job Location: This position is located at the Knipp Building; 3418 Knipp Drive, Suite F, Jefferson City, MO.

The Department of Social Services partners with families and communities to protect children, rehabilitate youth and move families to self-sufficiency so that Missourians can lead safe, healthy and productive lives.

Why you’ll love this position: This is an opportunity to join our dedicated and exceptional team of employees. Our team at Missouri Medicaid Audit and Compliance works to protect integrity of the Missouri State Medicaid Program by detecting and preventing fraud, waste and abuse, and recovering improperly expended Medicaid Funds, while ensuring high quality care for Missouri citizens.

What You’ll Do

• Plan, develop, and evaluate unit activities and operations completed on post-payment review of MO HealthNet claims to ensure providers are billing and providing services in accordance with federal and state regulations and MO HealthNet requirements.
• Maintain knowledge and understanding of MO HealthNet policies and procedures for the assigned programs related to the reviewing of Department of Mental Health providers.
• Supervise staff completing provider reviews of the Home and Community Based Waiver Services (HCBS) Development Disability waiver programs and other providers with the MHD program, including Department of Mental Health (DMH) Behavioral Health programs.
• Establish staffing needs, create productivity standards, and analyze workflow to determine if revisions are needed within the unit procedures
• Initiate and develop methods for analyzing and selecting claim samples, prepare communication regarding any trends, and make recommendations on policy updates or changes in the editing within the Medicaid Management Information System for the programs that are assigned.
• Coordinate activities between MMAC and various units of MHD, DMH, federal and state agencies, the fiscal agent, Medicaid providers, public agencies and private entities to meet common objectives and align with uniform procedures.
• Coordinate responsibilities with other supervisory staff within the MMAC Unit.
• Review and provide remarks on draft MHD manuals, bulletins, or policy changes as it pertains to assigned programs.
• Communicate effectively with other state agencies, providers, and coworkers regarding program requirements related to the reviewing of Department of Mental Health providers.
• Become knowledgeable regarding the whole audit process to ensure assigned staff have well-informed supervisor.
• Special assignments as assigned by the Director of the MMAC Unit or the Provider Review Manager. Limited overnight travel may be required
• May require the coordination and review of special projects, the development and management of tracking files, and coordinating efforts between other MHD units or other agencies.
• The individual in this position must be prepared to use his/her own professional judgment.
  
  

Minimum Qualifications

Bachelor’s degree and 2-4 years of relevant experience. (Substitutions may be allowed.)

Preferred Qualifications

• Great written and verbal communication skills
• Ability to work independently or in a team structure
• Demonstrate organizational skills, multitask while also prioritizing tasks
• Demonstrate and initiate problem solving
• Ability to communicate with stakeholders, contract vendors, and providers
• Attention to details
• Understand the analysis of data and comprehend the results
  
  

Lack of post‐secondary education will not be used as the sole basis denying consideration to any applicant.

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here .

If you have questions about this position please contact: Darla Weekley at Darla.L.Weekley@dss.mo.gov . If you experience accessibility issues while applying, please contact Courtney Hall at Courtney.A.Hall@dss.mo.gov .

Recruitment Area : All qualified applicants.

Application Deadline : April 4, 2025

The State of Missouri is an equal opportunity employer.