S

State of Nebraska

State government promoting agriculture

Administrator 2 - Medicaid Program Integrity and Provider Enrollment

Financial Crime & AMLConfirmed live in the last 24 hours
Full-timeLincoln, NE, USA$38.74 - $40.68 /hr

About the Job

Requirements

  • A Bachelor's degree in public administration, social work, human development, public health, behavioral science, law, finance, human resources, or another program-related field, plus four years of experience in a field related to the assigned program area, including supervisory experience; or a Master's degree in one of those fields and two years of commensurate experience. Equivalent experience or coursework/training may substitute for the educational requirement on a year-for-year basis.
  • A valid driver's license is required.
  • Knowledge of federal and state laws and regulations relevant to assigned programs.
  • Knowledge of quality assurance, performance improvement, and continuous improvement methods.
  • Knowledge of business and management principles, including strategic planning and resource allocation.
  • Knowledge of leadership, staff supervision, development, and coordination.
  • Knowledge of budget administration and fiscal management practices.
  • Skill in communicating information clearly to others.
  • Skill in using logic and reasoning to identify strengths and weaknesses of alternative solutions.
  • Skill in identifying complex problems, developing and evaluating options, and implementing solutions.
  • Ability to interpret and apply agency policies, procedures, and changing priorities.
  • Ability to analyze complex organizational and operational issues, draw conclusions, and develop timely, cost-effective solutions.
  • Ability to establish program objectives, formulate policies, and evaluate progress toward goals.
  • Ability to conduct high-level analysis and coordinate interrelated activities across multiple departments.
  • Ability to exercise sound judgment, decisiveness, and creativity in critical or unexpected situations.
  • Ability to establish and maintain effective working relationships with executive leadership, community organizations, elected officials, and the public.
  • Ability to plan, assign, and supervise the work of others.
  • Ability to evaluate current departmental strategies and processes and identify new or innovative strategies to prevent or detect provider fraud, waste, and abuse.

Responsibilities

  • Provide strategic leadership of Medicaid Program Integrity and Provider Screening business functions for the department.
  • Provide leadership and engagement in departmental business and technical projects and participate in department-wide initiatives and projects.
  • Provide oversight and guidance to business unit leaders to help set strategy, goals, and objectives aligned with agency objectives and federal and state regulations.
  • Partner at a leadership level with external stakeholders, including law enforcement agencies, the federal Centers for Medicare & Medicaid Services, the Attorney General's office, department contractors, other state agencies, and providers and associations.
  • Direct and coordinate the Program Integrity unit and the Provider Screening, Enrollment, and Revalidation unit, overseeing complex statewide programs.

Desired Qualifications

  • Five years of direct experience leading teams responsible for preventing and investigating healthcare fraud, waste, and abuse.
  • Five years of direct experience leading teams responsible for screening healthcare providers to determine their appropriateness to provide healthcare services.
  • Direct experience implementing large, complex business and technical projects.
  • At least two years of experience leading at least two healthcare-related business functions simultaneously.

About the Company

State of Nebraska

State government promoting agriculture

Nebraska is a U.S. state that provides government services to residents and supports the state’s economy, with a strong emphasis on agriculture. The state operates through agencies and programs that manage public education, infrastructure, health, safety, land use, and economic development, aiming to keep communities safe, informed, and prosperous. Its programs work by collecting taxes and fees, creating laws and regulations, and delivering services via state agencies, local governments, and partnerships with farmers, businesses, and non-profits. Nebraska differentiates itself from other states through its large agricultural sector and open land, which shape policies and programs around farming, water management, rural development, and access to markets. The goal is to sustain a stable, productive environment for residents and to support agricultural leadership and economic growth across the state.

Company size
5,001-10,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Lincoln, NE
Founded
1867

Recently Posted Jobs

Explore more opportunities at State of Nebraska

See more jobs