Long Term Care Specialist I

State of Vermont • Rutland, VT

1d

About The Position

The Department of Vermont Health Access (DVHA) is seeking a Long Term Care Specialist I for its Long Term Care Unit. The specialist manages a caseload to ensure prompt processing of case actions and independently applies, researches, and interprets Medicaid rules. Work is subject to less frequent review by mentors and supervisors than at more junior levels, and refresher training is required as appropriate.

The specialist re-determines program eligibility at prescribed intervals or when changes in a client’s circumstances require review. Work must be completed efficiently and on time to meet federal timeliness standards. The role may also involve preparing reports, fair hearing requests, and fraud referrals; testifying at Fair Hearings; and performing related or other assigned duties.

The State of Vermont describes its workplace as committed to transparency, integrity, service, diversity, equity, inclusion, and accessibility. Duties are performed largely in an office setting. Private transportation should be available for necessary travel to training, mentoring, and meetings.

Requirements

• Bachelor's degree; OR an associate degree and at least two years of experience in a related field; OR a high school diploma or equivalent and at least three years of experience in a related field.
• Qualifying experience may be in health care administration, insurance, banking, accounting, para-legal services, auditing, or federal grants management. Other related environments may qualify if they require reading, comprehending, and applying complex rules, regulations, policies, and procedures.
• Ability to work independently and research and interpret rules.
• Ability to complete work promptly and accurately amid a heavy workload, frequent interruptions, and shifting priorities.
• Private means of transportation should be available for necessary travel to training, mentoring, and/or meetings.
• Must pass any background investigation applicable to the position; checks may include Vermont and/or national criminal records, DMV, and adult and child abuse registries, as appropriate.

Responsibilities

• Maintain effective control of a caseload to ensure prompt processing of all case actions.
• Research, interpret, and apply Medicaid rules independently.
• Re-determine program eligibility at prescribed time frames or when changes in client circumstances require review.
• Complete work promptly and accurately to meet federal timeliness standards.
• Prepare reports, fair hearing requests, and fraud referrals as needed.
• Testify at Fair Hearings as needed.
• Perform related duties and other assigned duties as required.
• Attend refresher training as appropriate.

Benefits

• 80% State-paid medical premium and a dental plan at no cost for employees and their families
• 12 paid holidays each year and a generous leave plan
• State Paid Family and Medical Leave Insurance (FMLI)
• State defined benefit pension plan and deferred compensation 457(b) plan
• Tuition reimbursement
• Flexible spending healthcare and childcare reimbursement accounts
• Low-cost group life insurance
• Incentive-based wellness program
• Qualified Employer for Public Service Student Loan Forgiveness Program

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level