Medicaid Program Monitor - New Orleans, United States - State of Louisiana

State of Louisiana New Orleans, United States

1 week ago

Description

Supplemental Information

The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.

LDH serves as a model employer for individuals with disabilities.

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Eligibility Program Operations / Orleans Parish

Announcement Number:
MVA/PJ/194019

Cost Center:
Position Number(s):

This vacancy is being announced as a Classified position and may be filled as a Probationary or Promotional appointment.

Working Job Description:

This position is located within Medicaid Eligibility Program Operations (EPO).The qualified candidate must have specific in depth Medicaid policy knowledge in the approximately thirty (30) Medicaid Service Programs.

The Incumbent provides evaluation, monitoring and development of the various training and processes within Eligibility Program Operations (EPO) to assure high quality and effective administration of service delivery, staff support and training.

This position requires the ability to perform advanced training and development work.

Work involves analyzing training needs, coordinating and conducting training sessions using a variety of training methods, and developing and evaluating training programs.

May supervise the work of others. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment.

The incumbent must have knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects.

This position assures training standards are maintained at all levels. Assures development and delivery of training for field staff, contractors, and supervisory staff. Evaluate individual and organizational performance to ensure training is meeting business needs and improving performance. Identify training needs by consulting with stakeholders and using needs assessments. Develop and deliver training solutions that meet business needs. Optimize training processes for efficiency. Select and manage resources, including working with both internal employees and training vendors to develop and deliver training. Provide functional oversite to the technologies and technical personnel required to develop, manage and deliver training.

We are seeking a candidate who is highly adaptable, creative, ambitious, has analytical/critical thinking skills, sound communication and decision-making skills, forward- thinking and exemplifies leadership.

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.

Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.

A resume upload willNOT populate your information into your application. Work experience left off your electronic application or only included in an attached resumeis not eligible to receive credit

For further information about this vacancy contact:
Paula Jackson

LDH/HUMAN RESOURCES

BATON ROUGE, LA 70821

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

Minimum Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree plus three years of professional level experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.

SUBSTITUTIONS:
Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:

A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.

30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.

60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.

90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.

120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree.

Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience tosubstitute for the baccalaureate degree.

Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.

A master's degree in the above fields will substitute for one year of the required experience.

A Juris Doctorate will substitute for one year of the required experience.

Graduate training with less than a Ph.
D. will substitute for a maximum of one year of experience.

A Ph.
D. in the above fields will substitute for two years of the required experience.

Advanced degrees will substitute for a maximum of two years of the required experience.

NOTE:
Any college hours or degree must be from an accredited college or university.

Job Concepts

Function of Work:
To perform advanced research, analyses, and/or policy management activities for Medicaid programs.

Level of Work:
Advanced.

Supervision Received:
Broad from a Medicaid Program Supervisor or above.

Supervision Exercised:
None.

Location of Work:
Department of Health and Hospitals, Medical Vendor Administration.

Job Distinctions:
Differs from Medicaid Program Specialist 2 by the presence of advanced research, analysis and policy management responsibility.

Differs from Medicaid Program Supervisor by the absence of supervisory responsibility.

Examples of Work

Conducts audits of eligibility enrollment applications; prepares reports on results of each audit.

Prepares, interprets and clarifies eligibility policies and procedures.

Revises rules, regulations, and procedures to meet changes in law or policy.

Compiles data and proposes budgets for subprogram studies and proposed legislation; determines programmatic impact and composes response for

fiscal statements and fiscal notes.

Reviews current and proposed state and federal regulations and/or revisions to those regulations for hospitals and home health providers.

Evaluates new and/or revised regulations to determine the impact to the state Medicaid program.

Reviews audits performed by the contracted auditor to determine compliance with federal and/or state policies and regulations, which affect allowable costs.

Coordinates compliance monitoring of Medicaid Application Centers statewide.

Receives, approves and schedules all requests for Application Center Representative training.

Advises and assists field staff in performing on-site monitoring reviews to ensure that the Application Centers adhere to federal, state and agency

rules and regulations.

Assist in negotiating contractual agreements between the Department of Health and Hospitals and the Application Centers.

Provides functional supervision over contract staff.

Monitors and evaluates training provided by contract staff.

Prepares the annual budget request utilizing the prescribed format and addendums issued by the Office of Planning and Budget. Prepares detailed analyses

and narratives supporting and/or justifying the request as submitted. Responds to requests for additional information and modifications to the budget during

the legislative approval process.

Trains staff of all Medical Vendor Administration sections in fiscal management, budget development and variance reporting.

Develops training module and provides essential guidance to managers regarding preparing accurate, pertinent and substantiated data.

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