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Comprehensive Health Planner II - Repost

Augusta, Maine 04330 | Health & Wellness | Full-time

Apply by: Oct. 9, 2024

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Opening Date: September 25, 2024

Closing Date: October 9, 2024

Job Class Code: 5050

Grade: 26

Salary: $56,264.00 – $78,998.40

Position Number: 141000009

JOB DESCRIPTION:

The MHDO is required by Statute to create and maintain a comprehensive health care data base and to make the data available to the broadest extent possible while protecting individual confidentiality. This position is responsible for managing the overall requirements defined in 90-590 chapters 243, 247, 570 and 730, which includes MHDO’s health care data streams for the all-payer claims data, non-claims-based payments and other supplemental health care data, prescription drug pricing component data and cancer registry and vital statistics data. This position will also support the administrative and technical aspects of the rule making process at it relates to these data streams; and prepare the agency’s annual assessment calculations. This position will work closely with MHDO’s executive director and assist with projects as needed, finance director, and data vendor, as well as over 800 individual data submitters, which include health insurance companies, pharmaceutical manufactures, wholesale distributors and pharmacy benefit managers.

REQUIRED KNOWLEDGES:

• Knowledge of health care claims data

• Knowledge of claims file specifications and data standards

• Knowledge of pharmaceutical data and supply chain

• Knowledge of on-line tools and systems

• Ability to understand complex laws, rules, and regulations

• Ability to develop, organize, and complete projects on time

• Ability to work effectively both independently and with other team members

• Ability to manage several projects at once

• Ability to gather, synthesize, and summarize a variety of information from many sources

• Ability to communicate effectively both verbally and in writing

TYPICAL DUTIES:

• Establish and maintain contact with MHDO data submitters for each data stream

• Collaborate with MHDO’s data vendor on data submission compliance issues

• Identify specific data submission issues and work with the appropriate data submitters to address concerns

• Coordinate and participate in educational webinars with data submitters

• Draft and send various written communications to data submitters

• Participate in MHDO’s bi-montly data user group meetings

• Become the subject matter expert in the provisions and requirements in 90-590 Chapters 100, 243, 247, 570 and Chapter 730

• Manage all aspects of compliance with the data submission requirements in 90-590 Chapters 243, 247, 570 and chapter 730

• Collaborate with the executive director and finance director on identifying the entities subject to the annual agency assessment, calculating the individual assessment amounts, preparing and sending invoices, and managing follow up as needed.

• Collaborate with the executive director and team members in preparing the draft documentation required for proposed rule changes including both the administrative and technical expertise needed for Chapters 100, 243, 247, 570, 730, and other agency rules as requested

• Assist the executive director with special projects as requested

MINIMUM QUALIFICATIONS:

A Bachelor’s Degree in Public/Community Health, Health Administration, Health Sciences or Health Education; Public Administration, Government, Social Work, or a closely related field and three (3) years professional experience planning, development, coordination and/or evaluation of health programs or services -OR- an equivalent seven (7) year combination of education, training, and experience.

Preference will be given to those with experience working with “big data”, spefically health care data, including medical and pharmaceutical claims data, health care billing, health care coding, mapping data requirements to national standards, managing complex data submission rules, developing and managing relationships with hundreds of different entities.

Benefits of working for the State of Maine:

No matter where you work across Maine state government, you find employees who embody our state motto—"Dirigo" or "I lead"—as they provide essential services to Mainers every day. We believe in supporting our workforce's health and wellbeing with a valuable total compensation package, including:

• Work-Life Fit – Rest is essential. Take time for yourself using 13 paid holidays , 12 days of sick leave , and 3+ weeks of vacation leave annually. Vacation leave accrual increases with years of service, and overtime-exempt employees receive personal leave.

• Health Insurance Coverage – The State of Maine pays 85%-95% of employee-only premiums ($11,196.96 - $12,514.32 annual value), depending on salary. Use this chart to find the premium costs for you and your family, including the percentage of dependent coverage paid by the State.

• Dental Insurance – The State of Maine pays 100% of employee-only dental premiums ($387.92 annual value).

• Retirement Plan – The State contributes the equivalent of 13.29% of the employee's pay towards the Maine Public Employees Retirement System (MainePERS).

  State employees are eligible for an extensive and highly competitive benefits package (https://www.maine.gov/bhr/state-jobs/compensation-benefits) , covering many aspects of wellness. Learn about additional wellness benefits for State employees from the Office of Employee Health and Wellness (https://www.maine.gov/bhr/oeh/) .

  Note: Benefits may vary somewhat according to specific collective bargaining agreements and are prorated for anything less than full-time.

There's a job and then there's purposeful, transformative work. Our aim is to create a workplace where you can learn, grow, and continuously refine your skills. Applicants demonstrate job requirements in differing ways, and we appreciate that many skills and backgrounds can make people successful in this role.

As an Equal Opportunity employer, Maine State Government embraces a culture of respect and awareness. We are committed to creating a strong sense of belonging for all team members, and our process ensures an inclusive environment to applicants of all backgrounds including diverse race, color, sex, sexual orientation or gender identity, physical or mental disability, religion, age, ancestry, national origin, familial status or genetics.

If you’re looking for a great next step, and want to feel good about what you do, we’d love to hear from you. Please note reasonable accommodations are provided to qualified individuals with disabilities upon request.

Thinking about applying?

Research shows that people from historically excluded communities tend to apply to jobs only when they check every box in the posting. If you’re currently reading this and hesitating to apply for that reason, we encourage you to go for it! Let us know how your lived experience and passion set you apart.