Buyout Specialist

State of Utah

Job Description

This Buyout specialist position is with the Division of Medicaid and Health Financing, Office of Eligibility Policy. The Buyout program allows the State to purchase private health insurance for a Medicaid recipient if it is determined to be cost effective. The Buyout specialist analyzes whether it is cost effective to purchase the private insurance for these recipients after close coordination and gathering of information from Medicaid recipients, private health insurance, and COBRA brokers. This position will notify the Department of Workforce Services and Office of Recovery Services if the insurance is purchased.

Principal Duties

The candidate hired for this position will:

Act on Buyout referrals in a timely manner to determine if the State will purchase health insurance.
Review Buyout cases to determine if the case is still cost effective
Notify the Department of Workforce Services (DWS) and Office of Recovery Services (ORS) if the health insurance is purchased for the client.
Enter Buyout cost effective evaluation into the Medicaid Managed Care System (MMCS).
Report monthly statistics to management.
Act as a resource to internal staff, as well as clients, insurance representatives, and COBRA brokers to help answer questions regarding the Buyout program and case referrals.
Closely coordinate with other Buyout staff members to ensure referrals and reviews are processed timely.
Preferences:Working knowledge and experience with Medicaid Management Information System (MMIS), Medicaid Managed Care System(MMCS) and/or Electronic Resource Eligibilty Product (eRep).

If offered this position, your employment will be contingent upon passing a background check and review. There will be no cost to you for this check. This check will include fingerprinting, which will be available at various UDOH locations for your convenience. Fingerprinting will be completed prior to your first day of employment . You may review the policy by clicking HERE. (Download PDF reader)

Why work for the Utah Department of Health and Human Services? In addition to the rich benefitsthe State of Utah offers, the department offers:UTA Eco Pass, at a discounted rate
On-site Fitness Center, for a minimal membership fee
On-site Day Care Center with First Steps Day Care – contact for rates and availability, 801-538-6996

For more information on the Utah Department of Health and Human Services, please click here.


Typical Qualifications
(includes knowledge, skills, and abilities required upon entry into position and trainable after entry into position)

Has working knowledge and experience with MMIS, MMCS and eRep
Works effectively with clients and colleagues in a friendly and professional manner
Strives to find efficient and effective ways to deliver service
Able to collaborate with colleagues
Possess analytical and problem solving skills
Has working knowledge and experience with MS Word and Excel
Practices ethical behavior in the work setting

Supplemental Information

Risks found in the typical office setting, which is adequately lighted, heated and ventilated, e.g., safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.

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