DVHA Program Consultant - Limited Service

Have the work/life balance you need with a Monday-Friday schedule and a supportive hybrid work environment. Eleven paid state holidays, in addition to a robust benefits package.

The Casualty Team members work on the incoming requests to determine if the Department of Vermont Health Access (DVHA - VT Medicaid) has an interest in a settlement from an attorney or insurer. Requests come from attorneys, insurers, members, internally within DVHA, the Dept. of Motor vehicles data match report and the Dept. of Labor workers compensation data match report . The team creates electronic Casualty files and documents in associated Excel Spreadsheets and the TPL system. Using knowledge of medical terminology and anatomy the team chooses the correct diagnosis and medications relating to the injury or incident indicated by the insurance, attorney, or member to determine the total amount of related claims paid by DVHA.

The Casualty Team members correspond with the Assistant Attorney General's (AAG) Office, the Dept. of VT Health Access attorneys, external attorneys, and insurers. The team provides file updates, revisions, recoups, collects payments, and closes files. Closing files includes files with and without payment(s) via coordination and correspondence with the states' fiscal agent, Gainwell Technologies.

The team prepares reduction calculations and recommendations to the Supervisor and AAG's office to facilitate settlement agreements for collection and closure of files.

The Casualty Team facilitates the "End of Month" Casualty Process that is the accounting practices to ensure reconciliation of billed, collected, and recouped monies between DVHA, external stakeholders, and Gainwell. The Casualty Team collected $1,888,954.50 in State Fiscal Year (SFY) 22, $1,967,426.20 in SFY 23, and $1,504,054.71 in SFY 24.

Mission:
The Department of Vermont Health Access (DVHA)'s mission is to improve Vermonters' health and well-being by providing access to high-quality, cost-effective health care. We have identified three priorities that support our mission: Advancing value-based payments, modernizing information technology infrastructure, and operational performance improvement. Our department commits to executing our responsibilities and priorities while adhering to three core values: Transparency, Integrity and Service.

Diversity, Equity, and Inclusion:
As part of our values of transparency, integrity, and service, we are committed to supporting diversity, equity, inclusion, and accessibility as part of our person-centered culture. We actively celebrate our colleagues' and future colleagues' different abilities, racial identity, sexual orientation, ethnicity, age, and gender. Everyone is welcome and supported here.

Our State:
Vermont is a "small but mighty" state. We are ranked as one of the top 10 states to raise a family in 2022. We are nationwide leaders for progressive social and educational policies. We are in Northern New England, 1.5 hours from Montreal and 3.5 hours from Boston. We have beautiful Lake Champlain, the Green Mountains, and year-round outdoor activities.

Telework:
The Department of Vermont Health Access (DVHA) supports a hybrid work environment. Upon hire, employees work with their supervisor to create a schedule that aligns with the business needs of the unit. We believe a hybrid work environment promotes autonomy and allows for increased flexibility and greater work/life balan

This position, DVHA Program Consultant - Limited Service (Job Requisition #52416), is open to all State employees and external applicants. It is a Limited Service position, which is non-tenured and authorized for a specific period of time. Limited Service positions are established for specially funded projects or programs.

If you would like more information about the duration of this position or other details, please contactsamantha.prince@vermont.gov.
Please note that multiple positions in the same work location may be filled from this job posting.
Resumes will not be accepted via e-mail. You must apply online to be considered.

AHS BACKGROUND CHECKS: Candidates must pass any level of background investigation applicable to the position. In accordance with AHS Policy 4.02, Hiring Standards, Vermont and/or national criminal record checks, as well as DMV and adult and child abuse registry checks, as appropriate to the position under recruitment, will be conducted on candidates, with the exception of those who are current classified state employees seeking transfer, promotion or demotion into an AHS classified position or are persons exercising re-employment (RIF) rights.

Work is generally performed within the normal office setting.

Some means of private transportation must be available for field visits. Work activities during the evening or weekend may occur, and some out-of-state travel may be required. Conflicting opinions relative to the correct application of rules, regulations and policies can be anticipated.

Two (2) years or more of experience in a healthcare or health insurance field with experience in either accounting, auditing, federal grants management, business administration or public or health administration.

Bachelor's degree AND one (1) year or more of experience in a healthcare or health insurance field.

Experience in either accounting, auditing, federal grants management, business administration or public or health administration.

Basic knowledge of Medical Terminology & Anatomy

As a State employee you are offered a great career opportunity, but it's more than a paycheck. The State's total compensation package features an outstanding set of employee benefits that are worth about 30% of your total compensation, including:

• 80% State paid medical premium and a dental plan at no cost for employees and their families
• Work/Life balance: 11 paid holidays each year and a generous leave plan
• State Paid Family and Medical Leave Insurance (FMLI)
• Two ways to save for your retirement: A State defined benefit pension plan and a deferred compensation 457(b) plan
• Tuition Reimbursement
• Flexible spending healthcare and childcare reimbursement accounts
• Low cost group life insurance
• Incentive-based Wellness Program
• Qualified Employer for Public Service Student Loan Forgiveness Program

Want the specifics? Explore the Benefits of State Employment on our website.