Medicaid Program Specialist 2

The mission of the Louisiana Department of Health is to protect and promote health and to ensure access to medical preventive and rehabilitative services for all residents of the State of Louisiana.

Learn more about the Louisiana Department of Health

Join the Louisiana Department of Healths Medicaid Eligibility Quality team and help ensure eligible Louisianans receive the healthcare coverage they need. As a Medicaid Program Specialist 2 youll review complex eligibility cases resolve discrepancies support appeals and help ensure accurate timely decisions in accordance with Medicaid policy and federal requirements. If youre detail-oriented analytical and passionate about improving access to essential healthcare services apply today!

Four years of experience in research and analysis related to Medicaid programs; public health public relations social services health services or administrative services; OR

Six years of full-time work experience in any field plus one year of experience in research and analysis related to Medicaid programs; public health public relations social services health services or administrative services; OR

A bachelors degree plus one year of experience in research and analysis related to Medicaid programs; public health public relations social services health services or administrative services; OR

An advanced degree or a Juris Doctorate.

EXPERIENCE SUBSTITUTION:
Every 30 semester hours earned from an accredited college or university will be credited as one year of experience towards the six years of full-time work experience in any field. The maximum substitution allowed is 120 semester hours which substitutes for a maximum of four years of experience in any field.

The official job specifications for this role as defined by the State Civil Service can be found here.

Job Duties:

Reviews and analyzes assigned Medicaid eligibility cases to determine the accuracy and appropriateness of actions taken by field staff.

Investigates eligibility information and resolves case discrepancies using Medicaid policies procedures and applicable systems.

Processes Medicaid applications renewals case changes and appeals accurately and within federally mandated timeframes.

Re-processes eligibility determinations and clears issues in LaMEDS to ensure accurate and timely case actions.

Reviews cases for compliance with Medicaid eligibility requirements and applicable federal and state regulations.

Prepares and issues eligibility decision notices by entering required information into the appropriate Medicaid systems.

Maintains current knowledge of Medicaid verification systems policies procedures and program updates to support accurate eligibility determinations and protect continuity of coverage.

Location:Medical Vendor Administration / Eligibility Program Operations / East Baton Rouge Parish

Appointment Type: Probational orJob Appointment (temporary appointment that may last up to 48 months)

Cost Center: 305-2050401

Position Number(s):

No Civil Service test scoreis required in order to be considered for this vacancy.

To apply for this vacancy click on the Apply link above and complete an electronic application which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process.

Further status message information is located under the Information section of the Current Job Opportunities page.

*Information to support your eligibility for the position must be included in the application (i.e. relevant detailed experience/education).Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.

Contact Information:

LA Department of Health (LDH)

Division of Human Resources

PO Box 4818

Baton Rouge LA 70821

225-342-6477

This organization participates in E-verify and for more information on E-verify please contact DHS at 1-.

LDH supports Louisianas commitment to being a State as a Model Employer (SAME) by promoting the recruitment hiring and retention ofindividuals with disabilities.