Medicaid Program Specialist 1-2

State of Louisiana • Baton Rouge, LA

2d • 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. As a Medicaid Program Specialist, you’ll serve as a trusted first point of contact for Medicaid members, potential members, providers, and partners. Use your knowledge of Medicaid programs and eligibility to resolve questions, assist with case actions, and help callers access the coverage and services they need. If you’re knowledgeable, compassionate, and ready to make a meaningful impact through exceptional customer service, we encourage you to apply!

Requirements

• Three years of experience in research and analysis related to Medicaid programs; public health, public relations, social services, health services, or administrative services; OR Six years of full-time work experience in any field; OR A bachelor's degree.
• 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.
• Focusing on Customers: The ability to understand and meet the needs, preferences, and experiences of internal and external customers.
• 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 Initiative: The ability to assess situations independently and take proactive steps to address them without being prompted or instructed by others.
• Displaying Professionalism: The ability to uphold workplace standards through consistent conduct, responsible communication, and consideration for others.
• Learning Actively: The ability to pursue learning, seek feedback, and integrate new knowledge to improve personal and professional performance.
• Managing Time: The ability to prioritize tasks, meet deadlines, and allocate time to ensure timely completion of work goals.
• Solving Problems: The ability to identify root causes, analyze relevant data, and apply practical or innovative solutions to challenges.

Responsibilities

• Receive and respond to inbound calls from Medicaid members, potential members, providers, and other stakeholders, providing professional and courteous customer service.
• Provide accurate information and guidance regarding Medicaid programs, eligibility requirements, policies, procedures, and available services.
• Research and communicate case status and eligibility information using LaMEDS and other eligibility and ancillary systems.
• Process case actions, including duplicate card requests, case changes, and adding or removing individuals from cases.
• Review and interpret case notes, notices, and eligibility determinations to accurately address caller inquiries and resolve issues.
• Identify trends, potential errors, and discrepancies in communications, notices, or eligibility determinations and escalate issues through the appropriate chain of command.
• Educate callers and resolve inquiries whenever possible during the initial contact to help prevent delays, reduce gaps in coverage, and support timely access to Medicaid services.

Benefits

• Premium Pay of up to $2.00/hr for hours worked based on longevity.
• Bilingual applicants may be eligible for premium pay up to $2.50 hourly for hours worked only.

What This Job Offers

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