Program Specialist-Hybrid-160691

Job DescriptionJob Description

Program Specialist – Hybrid – Harrisburg, PA (160691)

Pay & Schedule

• Hourly Pay: $22.00/hr.
• Schedule: Monday – Friday, 7:30 AM – 4:00 PM
• Work Model: Hybrid – 2 days onsite in Harrisburg, PA, 3 days remote

Position Overview

We are seeking a Program Specialist to support the Medicaid Management Information System (PROMISe) and Electronic Client Information System (eCIS). In this role, you will assist with enrollment management, claims monitoring, and payment validation to ensure compliance with state and federal regulations while helping improve processes that directly impact program efficiency and timeliness.

Key Responsibilities

• Maintain a working knowledge of the Medical Assistance program.
• Process updates and corrections for Managed Care enrollment from MCOs and program offices.
• Support MCO capitation by validating and correcting payments.
• Identify and communicate claims system issues; work with technical staff to resolve.
• Recommend process or system improvements to increase productivity.
• Develop queries, prepare reports, and analyze reimbursement accuracy.
• Assist in program manual updates, data collection, and report preparation.
• Support provider enrollment/disenrollment, incident reviews, and fair hearing preparation as needed.
• Use HCSIS and CIS systems for data entry, screening, and research.
• Perform other duties as assigned.

Minimum Qualifications

• Bachelor’s degree in Human Services, Education, Sociology, Public Health, Healthcare Services.
• 1 year of professional experience in developing, implementing, or evaluating human services, sociology, public health, health care services, or health care insurance programs.
• Proficiency with Microsoft Office (Word, Excel, Outlook, Teams, PowerPoint).

/Helpful Qualifications

• Knowledge of Medicaid/Medical Assistance.
• Strong analytical and problem-solving skills with the ability to interpret data and trends.
• Ability to evaluate policies, contracts, and compliance requirements.

Keywords
Program Specialist Harrisburg, Medicaid Program Specialist, Medical Assistance, PROMISe, eCIS, Managed Care Specialist, Capitation Support, Claims Review, Healthcare Policy Analyst, Human Services Program Specialist, Hybrid Program Specialist Harrisburg PA, Data Analysis Healthcare, Medicaid Compliance Specialist.