Medicaid Ltc Analyst 1

About this Job

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.

About this position:

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Region 4 / Lafourche Parish

Announcement Number: MVA/PJ/208593

Cost Center:

Position Number(s): 172459

This vacancy is being announced as a Classified position and may be filled as a Probationary appointment or by Detail of a current classified Medicaid Employee.

This position has a Special Entrance Rate (SER) of:

Medicaid LTC Analyst 1 - $17.56 hr / $1404.80 bi-weekly

This position comes with a Premium Pay Rate of up to $2.00 per hour for hours worked only and based on years of service at Louisiana Department of Health (LDH), Office of Medical Vendor Administration (MVA) -Eligibility Field Operations (EFO):

0 months to less than 3 years - $1.00/hour

3 years to less than 6 years - $1.50/hour

6 years or greater - $2.00/hour

AN IDEAL CANDIDATE SHOULD POSSESS THE FOLLLOWING COMPETENCIES:

Accepting Direction: The ability to accept and follow directions from those higher in the chain of command.

Learning Actively: The ability to acquire necessary knowledge and skills to improve performance and achieve organizational goals.

Thinking Critically: The ability to objectively question, analyze, interpret, and evaluate information to form a conclusion.

Acting Decisively: The ability to make decisions quickly and effectively.

Adapting to Change: The ability to adjust plans, expectations, and behaviors in response to change.

Communicating Effectively: The ability to relay information correctly and appropriately to connect people and ideas.

Displaying Professionalism: The ability to recognize how your actions impact the perceptions of both you and your organization.

Focusing on Customers: The ability to serve the needs of those who support and/or rely on the services provided.

Following Policies and Procedures: The ability to comply with policies and procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws.

Solving Problems: The ability to discover solutions to problems.

Please click on the below links to learn more about each job level:

State Civil Service Job Information Finder

No Civil Service test score is 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.*

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:

Three years of experience in eligibility determinations for long-term care programs; OR

Six years of full-time experience in any field; OR

A bachelor's degree.

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.

Job Specification

FUNCTION OF WORK:

To perform initial determination of eligibility and ongoing case management for the Medicaid Long-Term Care program.

LEVEL OF WORK:

Entry.

SUPERVISION RECEIVED:

Direct from a Medicaid LTC Supervisor. Other reporting relationships may be approved by SCS.

SUPERVISION EXERCISED:

None.

LOCATION OF WORK:

Department of Health, Medical Vendor Administration. Other locations may be approved by SCS.

JOB DISTINCTIONS:

Differs from Medicaid LTC Analyst 2 by the absence of experienced-level eligibility and case management responsibilities.

Job Duties and Other Information

EXAMPLES BELOW ARE A BRIEF SAMPLE OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. NOT ALL POSSIBLE TASKS ARE INCLUDED.

Learns to determine financial and medical eligibility for Medicaid programs for individuals in Long-Term Care who are institutionalized either in a facility or at home.

Learns to interpret and apply complex federal, state, and agency policies to long-term care eligibility requirements.

Learns to evaluate financial and medical documentation to determine if the applicant is eligible for institutionalized services.

Acquires skill in the review of all case documentation, resolves discrepancies in financial eligibility and medical evidence from other agencies, and makes efforts to obtain required documentation and request additional documentation.

Learns to schedule interviews with applicants, representatives, and facilities to determine eligibility for Medicaid Long-Term Care programs.

Trains in the analysis of all sources of information related to provider forms and medical certifications when needed. Learns to determine if the medical certifications are consistent with provider forms and eligibility and, if necessary, resolves those inconsistencies.

Learns to examine application packets for timeliness, completeness, and appropriateness prior to authorization.

Learns to consult with internal and external professionals including advocacy groups, attorneys, providers, nursing facilities, corporate executives, and financial institutions. Considers hardships and penalty periods when making determinations.

Learns to determine and reconcile recipient financial liabilities to providers. Learns to determine and reconcile incurred medical expenses and other deductions that may impact financial liability.

May be assigned directly to providers or facilities.