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Managed Care Program Compliance Monitor (Executive II)

Job Requisition ID: 53928 BPIS: 12061 Opening Date: 03/02/2026 Closing Date: 03/16/2026 Agency: Department of Healthcare and Family Services Class Title: EXECUTIVE II - 13852 Skill Option: None Bilingual Option: None Salary: Anticipated starting salary $6,589/monthly; Full salary range $6,589 - $9,541/monthly Job Type: Salaried Category: Full Time County: Sangamon Number of Vacancies: 1 Bargaining Unit Code: RC062 Technical Employees, AFSCME Merit Comp Code: This position is a union position; therefore, provisions of the relevant collective bargaining agreement/labor contract apply to the filling of this position. All applicants who want to be considered for this position MUST apply electronically through the <a href="https://illinois.jobs2web.com/" target="_blank" rel="noopener">illinois.jobs2web.com</a> website. State of Illinois employees should click the link near the top left to apply through the <a href="https://hcm20.ns2cloud.com/sf/careers/jobsearch?bplte_company=SILHCM20P1" target="_blank" rel="noopener">SuccessFactors</a> employee career portal. Applications submitted via email or any paper manner (mail, fax, hand delivery) will not be considered. 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 Managed Care is seeking to hire an individual to serve as the Managed Care Compliance Coordinator. This position reviews and coordinates compliance activities with the Medicaid Managed Care Programs. These activities include communicating with outside entities and vendors, tracking program payments, and researching, analyzing, and interpreting program data and policies. The position will also consult with management on the development and interpretation of policies and procedures, goals and objectives of the program and serve as a liaison to outside agencies. The ideal candidate will be familiar with Medicaid principles and have familiarity with the Medicaid Managed Care Programs and Health Plans. HFS values employees with different backgrounds, life experiences, and talents. Employees receive a robust benefit package including: <ul style="margin-top:0.0in;margin-bottom:0.0in" type="disc"> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Monday-Friday work schedule</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Flexible work schedules are available in many program areas. (Remote work may be an option for certain positions.)</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Health, Life, Vision, and Dental Insurance</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Pension Plan</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Paid Parental Leave</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Deferred Compensation Program and other pre-tax benefit programs (Medical/Daycare)</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Employees earn (12) paid Sick Days annually.</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">New Employees earn (10) paid Vacation Days their first year of service and can earn up to (25) paid Vacation Days annually.</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">Employees earn (3) paid Personal Days annually.</li> <li style="color:#212121;background-color:white;margin-top:0.0in;margin-right:0.0in;margin-bottom:8.0pt;line-height:107%;font-size:14.0pt;font-family:arial, helvetica, sans-serif">(13-14) paid holidays annually (based on start date)</li> </ul> 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.<div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><h2 style="font-size:1.0em;margin:0.0px">Essential Functions</h2> </div><div><ul> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Under general direction, serves as the Managed Care Program Compliance Monitor by organizing, planning, and evaluating the Statewide Managed Care Organizations (MCO) Medical Compliance Program</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Evaluates the disposition of MCO complaints, including the review of documentation, drafting reports, and tracking systems</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Plans and organizes the registration and approval of MCO providers</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Serves as Bureau liaison</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Investigates, analyzes, tracks and responds to payment issues by MCOs</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Organizes, plans, and evaluates the research of MCO requests for disenrollment’s for cause</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Performs other duties as required or assigned which are reasonably within the scope of the duties enumerated above</li> </ul></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><h2 style="font-size:1.0em;margin:0.0px">Minimum Qualifications</h2> </div><div><ul> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Requires knowledge, skill and mental development equivalent to completion of four (4) years of college, preferably with courses in business or public administration</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Requires two (2) years of responsible administrative experience in a public or business organization</li> </ul></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><h2 style="font-size:1.0em;margin:0.0px">Specialized Skills</h2> </div><div><ul> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience researching and analyzing statistical data and drafting reports with outcomes</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience performing contract oversight of mandatory managed care organizations or similar types of health care programs or plans</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience explaining Medicaid or contract policy to outside entities including vendors, such as providers</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience creating, maintaining, and updating extensive Word documents, such as contracts or policies, and complex Excel spreadsheets with formulas</li> </ul></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><h2 style="font-size:1.0em;margin:0.0px">Preferred Qualifications</h2> </div><div><ul> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience researching and analyzing statistical data and drafting reports with outcomes</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience working with mandatory managed care organizations or similar types of health care programs or plans</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience explaining Medicaid or contract policy to communicating with outside entities including vendors, such as providers</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">One (1) year of experience creating, maintaining, and updating extensive Word documents and complex Excel spreadsheets with formulas</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Two (2) years of experience developing and managing a supportive program for a public or private organization</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Two (2) years of experience working with the principles and practices of public and business administration</li> </ul></div></div><div style="padding:10.0px 0.0px;border:1.0px solid transparent"><div style="font-size:16.0px;word-wrap:break-word"><h2 style="font-size:1.0em;margin:0.0px">Conditions of Employment</h2> </div><div><ul> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Requires completion of a background check and self-disclosure of criminal history</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Requires the ability to utilize and maintain state issued equipment such as a laptop</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">Overtime is a condition of employment, and you may be requested or required/mandated to work overtime including scheduled, unscheduled or last-minute overtime. This requires the ability to work evenings and weekends</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">The conditions of employment listed here are incorporated and related to any of the job duties as listed in the job description</li> </ul></div></div></div>Work Hours: Monday - Friday 8:30 am - 5:00 pm Headquarter Location: 201 S Grand Ave E, Springfield, Illinois, 62704 Work County: Sangamon Agency Contact: HFS.DMPApps@illinois.gov Posting Group: Leadership & Management This position DOES contain “Specialized Skills” (as that term is used in CBAs). APPLICATION INSTRUCTIONS Use the “Apply” button at the top right or bottom right of this posting to begin the application process. If you are not already signed in, you will be prompted to do so. State employees should sign in to the career portal for State of Illinois employees – a link is available at the top left of the <a href="http://Illinois.jobs2web.com">Illinois.jobs2web.com</a> homepage in the blue ribbon. Non-State employees should log in on the using the “View Profile” link in the top right of the <a href="http://Illinois.jobs2web.com">Illinois.jobs2web.com</a> homepage in the blue ribbon. If you have never before signed in, you will be prompted to create an account. If you have questions about how to apply, please see the following resources: State employees: Log in to the <a href="http://hcm20.ns2cloud.com/sf/careers/jobsearch?bplte_company=SILHCM20P1" target="_blank" rel="noopener">career portal</a> for State employees and review the <a href="http://www2.illinois.gov/sites/work/Documents/pdfs/InternalApplicant.2021.07.pdf" target="_blank" rel="noopener">Internal Candidate Application Job Aid</a> Non-State employees: on <a href="http://Illinois.jobs2web.com">Illinois.jobs2web.com</a> – click “Application Procedures” in the footer of every page of the website. 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: <ul> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">donotreply@SIL-P1.ns2cloud.com</li> <li style="font-family:arial, helvetica, sans-serif;font-size:14.0pt">systems@SIL-P1.ns2cloud.com</li> </ul>

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