Job Description

We are hiring an Agency Management Analyst for one of our clients in Hamilton, NJ.

Job Description:

Tasks to be completed

• Review and sort the fair hearings received (termination or denial) versus status review submissions and other non-fair hearing related mail
• Complete Master Tracking log entry for each fair hearing requested
• Prepare Acknowledgement letters and prep for mailing
• Batch fair hearing requests for Conduent to reinstate coverage for terminated cases, conduct informal review of original negative eligibility decision (termination or denial)
• Review results of Conduent's informal review to indicate State agreement or disagreement with Conduent's decision
• Where original negative case action is upheld by State Unit, initiate contact with household to explain outcome, determine if household wants to proceed with hearing before an ALJ with benefits to be continued, or if the household wishes to withdraw their FH request
• Prepare and mail out formal Withdrawal request form to households that consent to withdraw
• Follow up on missing Withdrawal request forms until closeout of referral is achieved (involves telephone outreach to members)
• Prepare cases for hearings before an ALJ in those instances where families wish to continue fair hearing process
• Attend fair hearings on behalf of the agency

Skills required:

• Two years of experience in clerical work, including reviewing, verifying, and looking up information in a case management system
• Skilled in Microsoft Office Suite
• Medicaid eligibility experience is preferred
• Committed to serving people the best way possible through government healthcare programs.
• Excellent communication and interpersonal skills with demonstrated ability to build bridges of understanding with all levels of stakeholders.
• Positive energy and eagerness to embrace diverse colleagues and communities.
• Motivated to work independently and in teams towards shared goals.
• Curiosity and positive energy to learn and grow in the organization.

Justification:

• The request is for two temporary staff to augment the SMU's ability to manage the incoming and backlogged fair hearing requests that have increased exponentially due to the Public Health Emergency (PHE) unwinding.

Background:

• In March of 2020, we experienced a nationwide Public Health Emergency (PHE) that spanned three years.
• The Centers for Medicaid and Medicare (CMS) advised States to not terminate any active member who was receiving New Jersey Family Care (NJFC) benefits.
• The PHE ended in April 2023, and CMS advised states to begin terminating individuals who were no longer eligible for the NJFC program.
• As a result, the State Monitoring Unit saw an increase in the number of fair hearing requests received.
• This led to the unit of three individuals to being inundated and overwhelmed.
• The SMU has received close to two thousand fair hearing requests since August, resulting in delays of benefits being reinstated and coordination of their HMO with eligibility effective date.

Work hours:

• 9:00 AM 5:00 PM, 35 hours a week
• Lunch Duration: 1 hour Unpaid

About Us:

We are specialized in recruiting and deliver the best professional talent of industry and we are committed to deliver best experience for our clients and job seekers. With over two decades of experience in the recruitment industry, we proudly help you to find the next job that matches your professional skills. Our team understands your needs or requirement before starting the recruitment, that enables to find the high quality of talent with high success rate of talent delivery, keeps us continue to be the best in the industry. By responding to this job posting, you are consenting to receive text/SMS messages from us. Thank you.

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