Claims Management Program Analyst (O-4 Billet) Non-Supervisory

DUTIES AND RESPONSIBILITIES: Serves in the capacity as a Claims Management Program Analyst; handles and assists program activities and policies related to claims management, and provider recruitment. Assumes leadership role as acting claims management program analyst lead when necessary. Serves as CMP representative between IHSC, third-party administrator, CBP components, and ICE ERO components in coordinating care and recruitment of off-site community provider for illegal aliens. Assist in developing, evaluating, and coordinating CMP related functions to ensure adherence to industry practices in eligibility verification, authorization of care, claims management denials and appeals to minimize adverse outcomes related to timely filing and maintaining a Provider Network to provide quality specialty care to illegal aliens. Duties include assisting in day-to-day managing, assessing, planning, developing, implementing, and evaluating assigned programs. Incumbent assists with reviews of pol