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Medical Certification Specialist 1 - 2

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Medical Certification Specialist 1 - 2

Salary

$5,119.00 - $9,211.00 Monthly

Location

Jefferson, LA

Job Type

Classified

Job Number

210752

Department

LDH-Jefferson Parish Human Services Authority

Opening Date

07/17/2025

Closing Date

7/22/2025 11:59 PM Central

+ Description

+ Benefits

About this Job

At JPHSA, we are committed to providing quality behavioral health, developmental disabilities, and primary care services and supports. Make a difference in the community and join our team today.

The Medical Certification Specialist is a key position within JPHSA’s Developmental Disabilities Community Services (DDCS) Division. The incumbent is responsible for providing technical assistance and training to private support coordination and private service agencies providing Medicaid Home-and-Community-Based Waiver Services (Waiver Services).

Minimum Qualifications

A current Louisiana license in a health services field, health regulation field, or social services field plus two years of experience in hospital or nursing home administration, health services, health regulation, or social services; OR

A bachelor's degree plus two years of experience in hospital or nursing home administration, health services, health regulation, or social services; OR

A master's degree in a health services field, health regulation field, or a social services field plus one year of experience in hospital or nursing home administration, health services, health regulation, or social services.

Job Specification

The official job specifications for this role, as defined by the State Civil Service, can be foundhere (https://apps01.civilservice.louisiana.gov/onestopjobinfo/DisplayJobSpec.aspx?JobCode=163910) .

Job Duties and Other Information

As a Medical Certification Specialist, you will,

• Reviews Comprehensive Plans of Care (CPOC) for individuals participating in waiver services in the Louisiana Service Reporting Systems (LaSRS)

+ Evaluates CPOC for person-centered goals, individualized personal outcomes, cost effectiveness, and effectiveness of service delivery

+ Approves or returns for correction CPOCs based on assessment of compliance with state/federal regulations or established state standards pertinent to each of the waivers managed by the JPHSA/DDCS: New Opportunity Waiver (NOW), Supports Waiver (SW), Residential Options Waiver (ROW), and Children’s Choice Waiver (CCW)

+ Conducts home visits and/or telephone consultations with individuals, families, and other professionals as needed to resolve problems that compromise the individual’s health and safety. Answers questions, explains waiver operations, explains client rights and responsibilities, and improve the quality of waiver services

+ Assists as needed to expedite the submission of required information and documents in order to meet timelines for CPOC and/or revision approvals

+ Assists in resolving billing and other provider related problems to prior authorization

+ Ensures that waivers are certified within the required State Office for Citizens with Developmental Disabilities (OCDD) timeline

+ Reviews revisions that change the existing CPOC for appropriateness of service changes, supporting documentation, and correct calculations of service units

+ Reviews waiver recipient appeals of denied services; gathers information and prepares summary of evidence; presents testimony before Administrative Law Judge

+ Enters current CPOC dates in the Participant Services Database after each approval

+ Uploads Medicaid forms (i.e., form 142, form 148) into Louisiana Medicaid Eligibility Determination System (LaMEDS) for changes in a person’s demographics, certifications, closures/discharges

Position-Specific Details:

Appointment Type: Probational, Promotional, or Job Appointment

Career Progression: This position does participate in a Career Progression Group and can be filled as a Medical Certification Specialist 1 or 2.

Work Schedule: Work hours are 8:00 AM to 4:30 PM, Monday - Friday.

Compensation: The salary offered will be determined based on qualifications and experience.

Louisiana is a State As a Model Employer (SAME) that supports the recruitment, hiring, and retention of individuals with disabilities.

How To Apply:

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.

Information to support your eligibility for the position must be included in the application (i.e., relevant, detailed experience/education). Resumeswill not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.

Contact Information:

For further information about this vacancy contact:

Enjoli Lewis

Jefferson Parish Human Services Authority

3616 S. I-10 Service Road West, Metairie, LA 70001

[email protected]

504-838-5426

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

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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