Medicaid Program Monitor

State of Louisiana • Baton Rouge, LA

1d • 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. This position supports one of the largest and most complex healthcare programs in the state, serving approximately 1.7 million enrollees annually. Working within Eligibility Field Operations, you’ll play a key role in supporting Medicaid eligibility programs, training initiatives, and policy implementation that help ensure access to critical healthcare services for vulnerable populations across Louisiana. This is an excellent opportunity for a motivated professional seeking rewarding public service work with statewide impact.

Requirements

• Six years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR Six years of full-time work experience in any field plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR A bachelor’s degree plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR An advanced degree or a Juris Doctorate plus two years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.
• 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.

Responsibilities

• Analyzes post-eligibility reporting data to identify issues, recommend resolutions, and support continuous improvement of Medicaid eligibility processes and operations.
• Identifies training gaps within regional offices and develops and delivers remediation, refresher, and specialized training for internal staff, providers, and external partners.
• Assists with documenting and communicating procedural and policy changes related to Medicaid eligibility processes and escalates recommendations for review and implementation.
• Serves as a subject matter expert for LaMEDS system development, testing, troubleshooting, and issue review prior to escalation to the help desk.
• Conducts informal and formal audits, case reviews, and performance evaluations to ensure compliance with eligibility policies, procedures, and operational standards.
• Develops, updates, publishes, and maintains Medicaid eligibility training materials, reference guides, and informational resources within LDH repositories.
• Collaborates with regional management and state leadership to support statewide training initiatives, operational priorities, pilot projects, and other Eligibility Field Operations activities.

What This Job Offers

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