Medicaid Program Specialist 1-2

State of Louisiana • Baton Rouge, LA

8d • Onsite

About The Position

The Medicaid Program Specialist supports Louisiana Department of Health’s mission to protect and promote health and ensure access to medical, preventive, and rehabilitative services for Louisiana residents. The role guides Medicaid members and potential members through eligibility, applications, renewals, and case updates while providing empathetic, accurate, and culturally competent service. The position may be filled at the Medicaid Program Specialist 1 or 2 level based on the selected applicant’s qualifications.

The specialist maintains detailed working knowledge of Medicaid programs, policies, procedures, eligibility, and related systems to explain policies and eligibility determinations to members, potential members, and providers. The work includes processing applications and renewals, answering questions about case status and coverage, handling card and case-change requests, and interpreting case notes and notices. The position communicates by phone and relies on sound judgment, critical thinking, emotional intelligence, and effective interpersonal skills.

The position is in Medical Vendor Administration, Eligibility Field Operations, in East Baton Rouge. Appointment options include probational, job appointment (a temporary appointment that may last up to 48 months), promotional, or detail appointment for a current classified LDH employee. The position may qualify for premium pay of up to $2.00 per hour based on longevity; bilingual applicants may be eligible for up to $2.50 per hour for hours worked.

Requirements

• One of the following: three years of experience in research and analysis related to Medicaid programs, public health, public relations, social services, health services, or administrative services; six years of full-time work experience in any field; or a bachelor's degree.
• For the six-year work-experience qualification, each 30 semester hours earned at an accredited college or university substitutes for one year of experience, up to 120 semester hours and four years of experience.
• Ability to communicate effectively and demonstrate accountability, critical thinking, data use, acceptance of direction, emotional intelligence, initiative, and strategic thinking.

Responsibilities

• Maintain an extensive and precise working knowledge of Medicaid programs, policies, procedures, eligibility, and ancillary systems.
• Accurately communicate Medicaid policy and eligibility information to members, potential members, and providers.
• Use Medicaid eligibility policy and procedures to interpret and communicate eligibility determinations, including decision letters.
• Complete Medicaid applications and renewals.
• Provide information on case status and Medicaid program coverage.
• Process requests for duplicate cards and case changes, including demographic and income changes and adding or removing case members.
• Read and interpret case notes and notices.
• Communicate effectively with members, potential members, and providers by phone.
• Use empathy, problem-solving, patience, active listening, conflict resolution, emotional intelligence, creativity, time management, critical thinking, and social skills in interactions.
• Understand and apply cultural competency.

Benefits

• Premium pay of up to $2.00 per hour for hours worked based on longevity.
• Bilingual applicants may be eligible for premium pay of up to $2.50 per hour for hours worked.

What This Job Offers

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