Medicaid Ltc Specialist

State of Louisiana•Opelousas, LA

5d•Onsite

About The Position

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. Join the Louisiana Department of Health and make a meaningful impact on the lives of Louisiana residents! As a Medicaid LTC Specialist within the Long Term Care processing unit, you’ll play an essential role in determining Medicaid eligibility and helping individuals access critical healthcare services. This opportunity offers career growth within the Medicaid Analyst series, with advanced-level positions providing opportunities to lead, mentor, and support staff. If you’re ready to build your career while contributing to a program that serves approximately 1.7 million Louisianans, we encourage you to apply!

Requirements

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.
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.

Nice To Haves

Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning
Thinking Critically: The ability to analyze information objectively, identify connections across sources, and form logical, well supported conclusions.
Acting Decisively : The ability to make timely, confident decisions using sound reason.
Adapting to Change : The ability to demonstrate flexibility in thoughts, behaviors, and actions in response to evolving circumstances or unexpected change.
Displaying Professionalism: The ability to uphold workplace standards through consistent conduct, responsible communication, and consideration for others.
Focusing on Customers: The ability to understand and meet the needs, preferences, and experiences of internal and external customers.
Learning Actively: The ability to pursue learning, seek feedback, and integrate new knowledge to improve personal and professional performance.
Solving Problems: The ability to identify root causes, analyze relevant data, and apply practical or innovative solutions to challenges.

Responsibilities

Serves as a liaison with fiscal intermediaries and Medicaid Eligibility Systems staff to resolve recipient and provider service, eligibility, and payment discrepancies.
Researches and analyzes provider billing practices, system reports, and payment information to identify issues and recommend appropriate corrective actions or sanctions.
Conducts special studies, analyzes data, compiles reports, and completes projects related to Medicaid Long Term Care eligibility, liability rules, and program operations.
Reviews case samples for accuracy, completeness, quality, and compliance to support Medicaid program integrity and identify opportunities for improvement.
Analyzes federal performance data and program outcomes to identify trends, compare performance, and develop recommendations for operational improvements.
Conducts ongoing programmatic reviews to ensure compliance with state and federal regulations and collaborates with Information Technology staff to ensure policies are accurately reflected in system programming.
Participates in Medicaid training, continuous quality improvement initiatives, provider outreach, emergency preparedness activities, and assists with training Long Term Care staff.