Medicaid Program Manager 1APrint (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4743050) ApplyMedicaid Program Manager 1ASalary $4,784.00 - $9,381.00 MonthlyLocation Baton Rouge, LAJob TypeClassifiedJob NumberMVA/SP/203024DepartmentLDH-Medical Vendor AdministrationOpening Date11/26/2024Closing Date12/3/2024 11:59 PM Central
Description
Benefits
Supplemental InformationThe Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.LDH serves as a model employer for individuals with disabilities.This position is located within the Louisiana Department of Health / Medical Vendor Administration / Business Analytics / East Baton Rouge ParishAnnouncement Number: MVA/SP/203024Cost Center: 3052010301Position Number: 50398734This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary appointment, Promotional Appointment, or Detail to Special Duty.(Job appointments are temporary appointments that may last up to 48 months)No Civil Service test scoreis required in order to be considered for this vacancy.Occupational SummaryThis position is in the Bureau of Health Services Financing (BHSF), Louisiana's single state Medicaid agency within the Louisiana Department of Health (LDH). The Louisiana Medicaid Program, which provides healthcare services to low income individuals, has an annual budget of approximately $17.2 billion dollars, a staffing complement of almost 900 authorized employees and almost 500 contracted direct-support staff, and provides services to approximately 2 million enrollees annually. The program is a state of federal partnership financed with a combination of state and federal funds and governed by a complex body of state and federal laws, policies, regulations, and guidelines. The incumbent will serve as the Unit Manager over the centralized unit for Medicaid Reporting. The position is directly responsible for ensuring accuracy and reliability of data collected and reported across all areas of Medicaid statewide, including but not limited to the compilation of data for LDH Medicaid reports. Due to the vast scope and complexity of the statewide reporting, it is crucial that the department create a centralized reporting unit. This unit is essential to review and analyze the large amounts of complex, multi-source data as well as system reports to ensure compliance with state and federal requirements.This position serves as the project lead on several key federal and state legislative reporting initiatives under the purview of the Reporting Unit of the Medicaid Business Analytics Section. The selected candidate will need to develop and maintain a broad level of knowledge across programs within Medicaid, must be attentive to detail, able to focus on different projects at one time, manage time wisely, work independently, apply Medicaid rules and policies to the interpretation of data, and ensure the timely publication of accurate reporting to meet regulatory requirements.The incumbent develops solutions and recommendations in conjunction with LDH program staff, federal and state partners to improve or resolve all data quality issues that affect internal and external reporting. The incumbent exercises a high degree of independent judgment and initiative in addressing non-routine matters as well as normal job duties/responsibilities with minimal direction.Major responsibilities:(50%) Administers the day-to-day operational functions for the compilation and publication of at least one major annual report, one quarterly state or federal report. Manages and maintains project management system for reports including a repository for data, documents and documentation of project work flows needed to ensure completion of accurate and timely report. Validates accuracy and reasonableness of data compiled, develop appropriate data visuals and compiles written summary of the reporting requirements, program background, methodology and data interpretations required to meet regulatory requirements. Monitors for any updates to reporting requirements. Works with Program Manager to develop new methodologies for data collections, data validation and report presentation to ensure continued compliance with federal and state reporting requirements.(20%) Manages the production of other assigned monthly reports and dashboards to comprehensively report on departmental initiatives to ensure quality inputs and meaningful outcomes and or federal and state statutory requirements. Conducts periodic evaluation of the utility of data and format presented. Researches and identifies new opportunities for improvement and expanded use.(10%) Develops methodologies for new reports assigned. Analyzes requester data needs and end product. Directs the design ofinternal and external reports, interpreting data and formulating appropriate conclusions supported by the data. Identifies and documents any data limitations and biases that might affect the results. Manages the production and distribution of these reports according to designated(10%) Prepares regular project updates to keep management informed of project status, timelines and issues. Makes recommendations for process improvements and/or adjustments needed based on change in programs or legislation. Develops and implements corrective actions or process adjustments as required. Conducts and directs studies or special projects pertaining to programs as assigned.(10%) Provides backup for other section positions and performs other duties and functions as assigned including but not limited to assisting other Business Analytics Program Managers not listed herein in order to meet the needs and functions of the Business Analytics and the Department.To apply for this vacancy, click on the “Apply” link above and complete an electronic application, which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.A resume upload willNOTpopulate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive creditFor further information about this vacancy contact:Shambrielle PoolerShambrielle.Pooler@la.govLDH/HUMAN RESOURCESBATON ROUGE, LA 70821This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218. Minimum QualificationsMINIMUM QUALIFICATIONS:A baccalaureate degree plus four years of professional experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.SUBSTITUTIONS:Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience tosubstitute for the baccalaureate degree.Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; public relations; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.A master's degree in the above fields will substitute for one year of the required experience.A Juris Doctorate will substitute for one year of the required experience.Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.A Ph.D. in the above fields will substitute for two years of the required experience.Advanced degrees will substitute for a maximum of two years of the required experience.NOTE:Any college hours or degree must be from an accredited college or university.Job ConceptsFunction of Work:To administer small and less complex statewide Medicaid program(s).Level of Work:Program Manager.Supervision Received:Broad from a higher-level manager/administrator.Supervision Exercised:May provide functional supervision in accordance with the Civil Service Allocation Criteria Memo.Location of Work:Department of Health and Hospitals.Job Distinctions:Differs from Medicaid Program Monitor by responsibility for administering small and less complex statewide program(s).Differs from Medicaid Program Manager 1-B by the absence of supervisory responsibility.Differs from Medicaid Program Manager 2 by the absence of responsibility for administering medium size and moderately complex statewide program(s).Examples of WorkSupervises the auditing of eligibility enrollment of all Medicaid programs statewide.Reviews work of eligibility review staff for quality assurance.Plans, coordinates, and controls small or less complex statewide program(s).Plans, develops, implements and monitors comprehensive Medicaid program policies.Conducts and directs studies/special projects pertaining to the programs assigned.Analyzes the impact of federal, state, and local legislation; advises agency officials; prepares position statements; presents testimony at hearings; writes legislation.Reviews and analyzes complex data and system reports to ensure compliance with program regulations.Administers the day-to-day operational functions of the Medicaid fee for service programs. Assures that program policy and procedures are properly applies in accordance with federal and state laws and regulations.Develops and writes agency rules and regulations governing the administration of all supervised Medicaid programs and submit them for publishing in the official state publication in accordance with the requirements of the Administrative Procedures Act.Implements Medicaid regulations directing provider participation standards and recipient benefits. Analyzes multi-mullion dollar Medicaid claim data and project the fiscal impact for budget forecasting.Identifies, verifies and analyzes the various revenue sources for the program(s). Determines and/or confirms match requirements. Monitors availability of revenue sources and promptly identifies existing or potential financing problems.Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity tomake a differencethrough public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career. As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:Insurance Coverage More information can be found at https://info.groupbenefits.org/Parental Leave– Up to six weeks paid parental leaveMore information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspxHolidays and Leave – State employees receive the following paid holidays each year:
New Year's Day
Martin Luther King, Jr. Day,
Mardi Gras,
Good Friday,
Memorial Day,
Independence Day,
Labor Day,
Veteran's Day,
Thanksgiving Day and Christmas Day.
Additional holidays may be proclaimed by the GovernorState employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):
Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video (https://lasersonline.org/wp-content/uploads/2016/07/YourRetirementSystem.mp4) to give you more detailed information about their system
Teacher's Retirement System of Louisiana (www.trsl.org),
Louisiana School Employees Retirement System (www.lsers.net), among others
AgencyState of LouisianaAddressFor agency contact information, please refer tothe supplemental information above.Louisiana State Civil Service, Louisiana, 70802Phone(866) 783-5462Websitehttp://agency.governmentjobs.com/louisiana/default.cfmApplyPlease verify your email addressVerify Email
