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MEDICAID PROGRAM MANAGER 4

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MEDICAID PROGRAM MANAGER 4

Salary

$7,046.00 - $13,825.00 Monthly

Location

Baton Rouge, LA

Job Type

Classified

Job Number

MVA/PJ/208518

Department

LDH-Medical Vendor Administration

Opening Date

05/09/2025

Closing Date

5/23/2025 11:59 PM Central

+ Description

+ Benefits

+ Questions

About this Job

The 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 / Eligibility Program Operations / East Baton Rouge Parish

Announcement Number: MVA/PJ/208518

Cost Center: 305-2050401

Position Number(s): 50531090

This vacancy is being announced as a Classified position and may be filled as a Probationary or Promotional appointment.

No Civil Service test score is required in order to be considered for this vacancy.

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 willNOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit

For further information about this vacancy contact:

Paula Jackson

[email protected]

LDH/HUMAN RESOURCES

BATON ROUGE, LA 70821

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

Minimum Qualifications

MINIMUM QUALIFICATIONS:

Two years of the required experience for the following minimum qualifications must have been at the supervisory level or above:

Eight 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 five 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 five 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 four 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.

EXPERIENCE SUBSTITUTION:

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.

Job Specification

Function of Work:

To serve as the Section Chief administering all functions of large and complex Medicaid program(s).

Level of Work:

Administrator.

Supervision Received:

Administrative direction from a higher-level administrator/executive.

Supervision Exercised:

Supervision over lower-level positions in accordance with the Civil Service Allocation Criteria Memo.

Location of Work:

Department of Health and Hospitals.

Job Distinctions:

Differs from Medicaid Program Manager 3 by serving as the Section Chief administering all functions of large and complex Medicaid program(s) and supervision exercised.

Differs from Medicaid Deputy Director by the absence of responsibility for the day-to-day management of Medical Vendor Administration.

Job Duties and Other Information

The Eligibility Program Operations, Medicaid Program Manager 4 is responsible for overseeing the development, implementation, and management of Medicaid eligibility policy and procedures for the Louisiana Department of Health (LDH). This role ensures that eligibility policies and procedures are compliant with federal and state regulations, aligned with departmental goals, and effectively support access to health coverage for eligible individuals. The position provides strategic direction, supervises professional staff, and serves as a key advisor on eligibility related issues.

Key Responsibilities:

+ Directs the development and implementation of Medicaid eligibility policy in accordance with federal and state regulations.

+ Interprets complex eligibility rules and provides guidance to internal and external stakeholders.

+ Supervises a professional team responsible for;

+ Policy and procedure development, analysis, and implementation.

+ Medicaid eligibility appeals

+ Corrective Action Plan development and monitoring resulting from PERM and MEQC eligibility findings

+ LaHIPP eligibility processing and Medicare Buy-in functions

+ Oversight/enrollment of Medicaid Application Centers

+ Disability determinations made by Medical Eligibility Determinations Team (MEDT)

+ Coordinating Refugee Medical Assistance Program with the Louisiana Office of Refugees

+ Collaborates with other LDH offices, technology partners, and federal agencies to ensure coordinated policy and procedure execution.

+ Oversees the drafting of policy manuals, guidance documents, and procedures.

+ Prepares and delivers reports, presentations, and policy recommendations to senior leadership and legislative bodies.

+ Reporting of eligibility Performance Indicators through LaPAS

+ Serves with EFO Section Chief as Business Owners for LaMEDS, which involves prioritization of work, providing guidance for technical requirements and business review and serving as subject matter expert among other things.

+ Liaison for DCFS Child Welfare in matters concerning eligibility determinations.

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 leave

More information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx

Holidays 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 Governor

State 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/Your\_Retirement\_System.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

01

Do you have at least two years of experience at the supervisory level or above?

+ Yes

+ No

02

If you answered 'yes' to the previous question, please list which positions on your application were at the supervisory level or above. If you answered 'no,' please enter N/A.

Required Question

Employer

State of Louisiana

Address

For agency contact information, please refer to

the supplemental information above.

Louisiana State Civil Service, Louisiana, 70802

Phone

(866) 783-5462

Website

http://agency.governmentjobs.com/louisiana/default.cfm

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