Job Description

Agency: Department of Healthcare and Family Services

Class Title: SENIOR PUBLIC SERVICE ADMINISTR - 40070

BPIS: 07787

Skill Option: General Administration/Business Marketing/Labor/Personnel

Bilingual Option: None

Start Date: 4/8/25

Closing Date/Time: 04/22/2025

Salary: Anticipated starting salary range $10500-$12500/based on experience

Job Type: Salaried

Category: Full Time

County: Sangamon

Number of Vacancies: 1

Plan/BU: None

**************** A RESUME IS REQUIRED FOR THIS JOB POSTING ****************

Please attach a DETAILED Resume/Curriculum Vitae (CV) to the MY DOCUMENTS section of your application. You WILL NOT be considered for the position if you attach a CMS100, CMS100b or any other document that is not a Resume or CV.

Why Work for Illinois?

Working with the State of Illinois is a testament to the values of compassion, equity, and dedication that define our state. Whether you’re helping to improve schools, protect our natural resources, or support families in need, you’re part of something bigger—something that touches the lives of every person who calls Illinois home.

No matter what state career you’re looking for, we offer jobs that fit your life and your schedule—flexible jobs that provide the gold standard of benefits. Our employees can take advantage of various avenues to advance their careers and realize their dreams. Our top-tier benefits and great retirement packages can help you build a rewarding career and lasting future with the State of Illinois.

Position overview:

The Department of Healthcare and Family Services, Bureau of Rate Development and Analysis is seeking to hire a manager for the Encounter Data unit. We are seeking an experienced and self-motivated administrator to oversee the collection and validation of Managed Care Organization (MCO) encounter data used to monitor MCO performance and develop capitation rates. The candidate will demonstrate the ability to work effectively with a team of professionals to facilitate submission of complete and correct encounter data.

The ideal candidate will have supervisory experience, a working knowledge of medical claims data, excellent organizational and communication skills and possess the ability to effectively lead a team.

HFS values employees with different backgrounds, life experiences, and talents.

Employees receive a robust benefit package including:

• Monday-Friday work schedule
• Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)
• Health, Life, Vision, and Dental Insurance
• Pension Plan
• Paid Parental Leave
• Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)
• Employees earn (12) paid Sick Days annually.
• New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.
• Employees earn (3) paid Personal Days annually.
• (13-14) paid holidays annually (based on start date)

If you are seeking a new opportunity, and this position appeals to you, please apply today!

At the Illinois Department of Healthcare and Family Services (HFS), we value staff as our greatest asset. We work in a spirit of teamwork to help millions of Illinoisans access high quality healthcare and fulfill child support obligations to advance their physical, mental, and financial well-being. We provide healthcare coverage for children and adults through Medicaid and other medical programs, and we help ensure that children receive financial resources from both their parents through Child Support Services. The HFS Office of the Inspector General investigates, audits and reviews program activity to ensure the integrity of our programs is maintained.

HFS is committed to promoting and preserving a workplace culture that embraces diversity, equity, and inclusion. We welcome and value employees with different backgrounds, life experiences, and talents. It is the collective sum of our individual differences that provides a broad perspective, leading to greater innovation and achievement. In recruiting for our team, we recognize the unique contributions of each applicant regardless of culture, ethnicity, race, national origin, sex, gender identity and expression, age, religion, disability, and sexual orientation. HFS is an equal opportunity employer.

Essential Functions

• Subject to management approval, serves as the chief project manager to plan, develop, implement, evaluate and manage the encounter data program for the Division of Medical Programs, including improving submission rates of data, acceptance rates, compliance monitoring and analytic review of submitted data
• Develops and implements policies for interfaces with manages care contractors to develop Quality Improvement plans and Corrective Action plans to assure accurate encounter data is received by the Division
• Reviews and evaluates the Medicaid Management Information System (MMIS) system edits
• Serves as full line supervisor
• Performs other duties as required or assigned, which are reasonably within the scope of the duties enumerated above

Minimum Qualifications

• Requires knowledge, skill and mental development equivalent to completion of four (4) years of college
• Requires prior experience equivalent four (4) years of progressively responsible administrative experience in a public or business organization

Preferred Qualifications

• Minimum of two (2) years of healthcare or other similar data reporting experience, including but not limited to data definitions, submission, and editing
• Minimum of two (2) years of experience working with HIPAA transactions relevant to encounter data submission
• Minimum of two (2) years of experience working with large provider, health insurer, government agency, or research institution regarding a healthcare claims system
• Minimum of two (2) years of experience managing the business side of information technology projects
• Minimum of two (2) years of experience working with procedural and diagnosis coding
• Minimum of two (2) years of experience working with Medicaid policies and procedures
• A bachelor’s or advanced degree in healthcare, business or information systems is preferred

Conditions of Employment

• Requires completion of a background check and self-disclosure of criminal history
• Requires the ability to utilize and maintain state issued equipment such as a laptop
• Certain provisions of the revolving door restrictions contained in 5 ILCS 430/5-45 apply to this position. As a result, the employee should be aware that if offered non-State employment during state employment or within one year immediately after ending State employment, the employee shall, prior to accepting any such non-State employment offer, notify the Office of the Executive Inspector General for the Agencies of the Illinois Governor (OEIG) or may be subject to a fine
• This position has been found to meet the requirements in section 4A-101 of the Illinois Governmental Ethics Act requiring the occupant/employee to file a Statement of Economic Interest. The Illinois Governmental Ethics Act (5 ILCS 420/4A et seq.) requires certain state officials and employees to file annual Statements of Economic Interest with the Office of the Secretary of State that will be made available for examination and copying by the public. All employees required to file a Statement of Economic Interest are also required to file the Supplemental Statement of Economic Interest with the Executive Ethics Commission. (See Executive Order 15-09) Fines and penalties apply to untimely filings
  • The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description

Work Hours: Monday - Friday 8:30 a.m. - 5:00 p.m.

Work Location: 201 South Grand Ave E Springfield, IL 62704-3803

Agency Contact: HFS.DMPApps@illinois.gov

Posting Group: Leadership & Management

Revolving Door:
Certain provisions of the revolving door restrictions contained in 5 ILCS 430/5-45 apply to this position. As a result, the employee should be aware that if offered non-State employment during State employment or within one year immediately after ending State employment, the employee shall, prior to accepting any such non-State employment offer, notify the Office of the Executive Inspector General for the Agencies of the Illinois Governor (“OEIG”) or may be subject to a fine.

The main form of communication will be through email. Please check your “junk mail”, “spam”, or “other” folder for communication(s) regarding any submitted application(s). You may receive emails from the following addresses:

• donotreply@SIL-P1.ns2cloud.com
• systems@SIL-P1.ns2cloud.com

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