Medicaid LTC Specialist

Overview

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.

As a Medicaid LTC Specialist, you'll analyze provider data, resolve eligibility issues, and support program integrity in Long-Term Care. You will research complex cases, ensure policy compliance, and collaborate across teams to drive continuous improvement. If you are detail-oriented, enjoy problem solving, and want to impact Medicaid services, consider applying.

• Act as a liaison with the fiscal intermediary and Medicaid Eligibility Systems to address recipient and provider service/payment discrepancies and recommend sanctions when necessary.
• Perform special studies, analyze data, and complete reports to ensure program integrity and accuracy in Long-Term Care eligibility.
• Conduct ongoing programmatic reviews to ensure compliance with federal and state regulations, collaborating with IT staff to maintain accurate policy reflection in systems.
• Participate in Medicaid policy and procedure training, as well as provider outreach and emergency preparedness activities.
• Assist in training LTC staff and support continuous quality improvement initiatives using methodologies like Work Smart, Agile, and Lean Six Sigma.

Location: Medical Vendor Administration / Eligibility Field Operations / St. Landry Parish

Appointment Type: This is a promotional opportunity open only to current permanent employees in a classified position with Louisiana Department of Health, Medical Vendor Administration.

Cost Center: 2050405

Position Number:

Compensation: This position is eligible for Special Entrance Rates, plus a Premium Pay of up to $2.00/hr for hours worked based on longevity. Medicaid LTC Specialist - $24.35 hourly / $1,948.00 bi-weekly

• Six years of experience in eligibility determinations for long-term care programs; OR
• Six years of full-time experience in any field plus three years of experience in eligibility determinations for long-term care programs; OR
• A bachelor s degree plus three years of experience in eligibility determinations for long-term care programs; OR
• An advanced degree plus two years of experience in eligibility determinations for long-term care programs.
• 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.

No Civil Service test score is required to be considered for this vacancy. To apply, complete an electronic application and check status in the Current Job Opportunities page information section.

* Information to support eligibility must be included in the application. Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.

Shambrielle Pooler

Shambrielle.

Pooler

LA Department of Health (LDH) – Division of Human Resources

PO Box 4818, Baton Rouge, LA 70821

This organization participates in E-verify. For information, contact DHS at

LDH supports Louisiana’s commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.

Information on the Louisiana Works and Louisiana Rehabilitation Services is available here.