Policy and Program Management Specialist
40hrs/wk - Oklahoma Health Care Authority
Oklahoma City, Oklahoma
11.2023 - 11.2024
- Reviewed Mental Health Parity and Addiction Equity Act (MHPAEA) information and provided assessment of how it will impact Medicaid -Fee for Service
- Researched and disseminated information on Medicaid spousal impoverishment rates
- Conducted reviews of school based Medicaid rules and regulations via West Law for use in drafting state policy
- Researched and answered questions regarding policy revisions related to ADvantage Waiver
- Disseminated flow charts of how a state plan amendment and rule are promulgated to provide technical assistance to external parties on the steps a policy goes through from the initial need for a policy to it becoming policy
- Researched regs/guidance regarding how self-funded plans may participate in Medicaid premium assistance programs
- Assisted in the development of presentation on Medicaid 1115 Waiver Annual Report use Medicaid.gov and Westlaw to research other coverage and reimbursement policy on Medicaid funding for Fertility Preservation Services and advised agency staff on interpretation of new state statutes on these services
- Researched coverage and reimbursement policy related to Psychiatric Residential Treatment Facilities and provided information to division leaders
- Identified key areas the state Medicaid agency may need to explore policy changes including effective dates if any on best practices for adhering to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) requirements
- Conducted research on federal regulations for closure criteria for health plans, Eligibility and Coverages Services staff on recouping overpayments
- Developed process for fielding requests from external parties for state administrative code, Medicaid state plan amendment changes
- Editor of The Point, policy divisions' weekly newsletter containing high-level summary of latest CMS guidance, legislative tracking, and regulatory action, and other news as it relates to Medicaid and CHIP
- Conduct research, as needed, or as assigned by the Director and/or the Advisor, that supports policy and program proposals.
- Provide consultation and technical assistance to clients, providers, contractors, local agencies, and co-workers.
- Conduct frequent evaluations of records, files and other documents; personally review work activities of staff to determine quality and accuracy of work performed; analyze and evaluate both administrative and program plans and operations on an on-going basis.
- Establish timeframes needed to complete projects with regard to milestones & deadlines according to federal and state policy and/or agency goals.
- Prepare policy amendment work folders; assist in compiling applicable research, assist with policy revisions and drafting/review of other corresponding documents for submission and filing, and providing information to public health advisory committees as required.
- Utilize knowledge of the policy amendment process, timelines, history of SPA/projects to answer inquiries from internal/external staff.
- Assist the Senior Advisors and Coordinator by drafting and revising policy amendments for accuracy and formatting of document(s).
- Develop written timelines and monitor all required public notice processes associated with proposed changes in authorities based on assigned projects.
- Contribute to the composition of public notices and proposed policy summaries and publish to the OHCA website, proposed policy changes blog, and/or for newspaper publication as needed and/or requested by the Director and Advisor.
- Lead in tracking research requests and policy-related actions by the Agency’s Boards and Committees to report final resolution.
- Review federal and state approved policies to determine accuracy, identify discrepancies, and ameliorate changes needed.
- In collaboration with the Coordinator, update external and internal policies within agency based on approvals and assist in updates of agency policy with outside agencies.
- Make recommendations related to identifying, developing, preparing, and seeking state & federal approval of changes to the Medicaid & CHIP Programs and related policy, rules, procedures, and regulations for statewide implementation of major state and federal programs. Assist the Advisors in determination of appropriate policy decisions regarding the Medicaid program.
- Research federal regulations, and state regulations as needed, and various reference materials to determine legal authority for and validity of new and/or revised policy.
- Perform thorough research for policy inquiries, open records requests, and bill impacts.
- Consistently brief the Director on the progress of projects/research requests and keep the Director informed of issues as they arise.
- Maintain open communication with the Division and any program staff.
- Utilize sound expertise to internal and external customers as called upon.
- Research and advise agency personnel, outside agencies and the general public on the agencies current policies and provide guidance and train personnel on accessing policies.
- Research and investigate special areas of concern.
