Non-Modified Adjustment Gross Income Rules Engine Supervisor

Position overview

The Department of Healthcare and Family Services, Bureau of Eligibility Integrity, is seeking to hire a manager to oversee a team of Information System Analysts and Management Operations Analysts. As the Non-MAGI Rules Administrator, you will work with a large team of colleagues in HF and in other state agencies to improve the lives of Illinoisians by assuring that HFS Programs provide accurate health benefits coverage to eligible Illinoisians consistent with State and Federal requirements. You will become a part of a team committed to providing health benefits to maximize the health and well-being of our customers, with consistent and responsive customer service, and based on a foundation of equity for all customers.

The ideal candidate must have knowledge/experience of rules engine logic in a public means benefit system, understanding of relational databases, and creating complex SQL queries with knowledge of State and Federal Medicaid laws. The ideal candidate must be a proven leader, strong researcher, and have proven experience with SQL logic in a relational database. The ideal candidate will be able to demonstrate the ability to present data to explain complex medical policy in ways that are easy to understand for a variety of audiences.

The nature of the work is very collaborative and requires good working relationships with other staff and bureaus in HFS, other agencies, and contacts. This position is a fast-paced environment requiring flexibilities, excellent prioritization skills and dedication to teamwork.

HFS values employees with different backgrounds, life experiences, and talents. If you are seeking a new opportunity, and this position appeals to you, please apply today!

Essential Functions

• Subject to management approval, serves as the Non-Modified Adjustment Gross Income (MAGI) Rules Engine Supervisor in planning, directing and evaluating the statewide Non-MAGI Rules Engine Program


• Serves as full line supervisor


• Directs and implements the development of rules engine logic deployed to the rules engine for the accurate processing of medical eligibility decisions in accordance with State and Federal laws, rules and regulations


• As Rules Engine Specialist, attends meetings to present complex research findings and answer technical questions


• Monitors program functions to ensure compliance with Department guidelines and other State or Federal rules and regulations involving eligibility


• Performs other duties as required or assigned, which are reasonably within the scope of the duties enumerated above

Minimum qualifications

• Required knowledge, skill, and mental development equivalent to completion of four (4) years of college


• Requires prior experience equivalent to three (3) years of progressively responsible administrative experience in a public or business organization

Preferred qualifications

• Three (3) years of professional experience interpreting and analyzing Federal and State Medicaid and child health insurance laws


• Three (3) years of experience in database management system for automated decision-making comparable to Medicaid eligibility systems and experience applying rules engine logic to implement medical programs eligibility policy


• Three (3) years of professional experience analyzing large sets of data in comparison to administrative programs and adopting and effective course of action for a public or private organization, State or Federal agency


• Three (3) years of professional experience developing, installing, and evaluating new and revised methods, procedures, and performance standards to meet Federal and State guidelines


• Three (3) years of professional experience exercising judgement and discretion in developing, implementing, and interpreting organizational policies and procedures for a public or private organization, State or Federal agency


• Three (3) years of professional supervisory experience working with labor and employment development, including staff utilization and employee motivation


• Three (3) years of professional experience in Medicaid eligibility specifically administrative experience developing data abstracts with SQL software in regards to a relational database

Conditions of employment

• Requires completion of a background check and self-disclosure of criminal history


• Requires the ability to travel in the performance of duties, with overnight stays as appropriate


• Requires the ability to utilize and maintain state issued equipment such as a laptop and/or cell phone


• 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
  
  
  
  • The conditions of employment listed her are incorporated and related to any of the job duties as listed in the job description
  
  
  
  

About the agency

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.

Benefits statement

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)