Health Insurance Specialist

3 weeks ago


San Francisco, California, United States Centers For Medicare & Medicaid Services Full time

Establishes Medicaid policy related to Medicaid Managed Care programs and other policy areas of responsibility that are located within the division.

Advises on evaluating proposed new legislation and regulations to assess their impact on Medicaid prescription drug programs and Managed Care policies to enhance program operations and beneficiary services.

Performs independent analyses of Medicaid Managed Care programs and other policy areas to address issues affecting the effective management of Medicaid programs.

Processes and reviews state managed care program reports, network adequacy, and mental health parity documentation to ensure compliance with federal rules and requirements for Medicaid Managed Care plans.

Coordinates program assignments with internal and external stakeholders as required to diagnose problems and develop viable courses of action.

Provides specific and detailed information regarding operational policy and instructions for Medicaid Managed Care programs and policy or other policy areas of responsibility that are located within the division.



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