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MEDICAL CERTICATION SPECIALIST 1 OR 2 - WAIVERS

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MEDICAL CERTICATION SPECIALIST 1 OR 2 - WAIVERS

Salary

$5,119.00 - $9,211.00 Monthly

Location

Alexandria, LA

Job Type

Classified

Job Number

213154

Department

LDH- Central Louisiana Human Services District

Opening Date

09/22/2025

Closing Date

10/6/2025 11:59 PM Central

+ Description

+ Benefits

+ Questions

About this Job

Why work for CLHSD?

+ Vision: CLHSD excels at making lives better.

+ Mission: to increase public awareness of and to provide access for individuals with behavioral health and developmental disabilities.

+ Philosophy: to integrate community-based services while promoting wellness, recovery, and independence through education and choice of a broad range of programmatic and community resources.

We’re looking for aMedical Certification Specialist 1 or 2to use highly developed professional skills to provide technical assistance, consultative services, programmatic oversight and direction to support coordination agencies as well as service agencies and Support & Service Centers regarding quality of services, compliance with Medicaid guidelines for waiver certification, assuring health and safety of HCBWS consumers, and service delivery. Employee must be knowledgeable of and familiar with the region-wide resources in order to recommend/refer individuals and/or service agencies to such for assistance.

AN IDEAL CANDIDATE SHOULD POSSESS THE FOLLOWING COMPETENCIES:

Selected Preferred Competencies:

+ Accepting Direction:The ability to accept and follow directions from those higher in the chain of command.

+ Acting Decisively:The ability to make decisions quickly and effectively.

+ Communicating Effectively:The ability to relay information correctly and appropriately to connect people and ideas.

+ Driving Results:The ability to identify important goals and work to achieve them.

+ Focusing on Customers:The ability to serve the needs of those who support and/or rely on the services provided.

+ Following Policies and Procedures:The ability to comply with policies and procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws.

+ Making Accurate Judgments:The ability to form an opinion objectively and decisively based on relevant information and in accordance with established standards.

+ Working Safely:The ability to maintain safety by following rules and procedures.

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

Job Duties:

+ Receives and reviews in detail all components of an individual’s initial comprehensive plan of care package for approval of home and community-based services, making a determination decision within 10 business days of receipt as identified in federal and state Medicaid guidelines.

+ Upon receipt of all initial comprehensive plans of care for a new applicant, incumbent must visit the individual’s home to discuss service requested, ensure freedom of choice was offered, assess the effectiveness and quality of planning process, ensure personal goals and outcomes are identified and are addressed in the comprehensive plan of care, and assess health and safety components for community living. Incumbent provides recommendations to the Support Coordination Agency and/or Service Provider Agency based on information gathered at the initial home visit.

+ Annually and as needed, the incumbent will review and evaluate overall effectiveness of individuals’ comprehensive plans of care ensuring personal outcomes and person-centered goals are identified appropriately within each plan of care, as well as evaluate how support identified will ensure the individual’s health and safety in the community setting.

+ All returns or denials of incomplete plans to Support Coordination Agencies are provided with the incumbent providing communication via written communication through Louisiana Statistical Resources System (LaSRS) to Support Coordination Agencies regarding methods of improving or clarifying requested service support.

+ Incumbent identifies, coordinates and communicates with supervisor regarding recurring issues/problems with Support Coordination Agencies regarding methods of improving comprehensive plans of care submitted to Waiver Supports and Services Unit.

+ Incumbent receives emergency and non-emergency service plan revisions to review for the appropriateness of changes in services that are requested and necessary for the care of the individual.

+ For all denials of home and community-based waiver services requested, incumbent prepares a notification letter to the individual or family detailing the reason for denial based on policy and procedure.

+ As assigned by administrative staff, incumbent follows all assigned critical incident reports submitted electronically into the SIMS (Statewide Incident Management System) by the Support Coordination and Provider Agencies.

+ High Risk situations require more in-depth involvement by incumbent in planning and may require active participation in the assessment and planning process; including on-going interaction with Interdisciplinary Team Members (IDT) and/or possible on-site home visit with the participant to ensure the health and safety of the participant.

+ Completes Level of Care (LOC) assessments and approval/denial of ACT 421 Children’s Medication Option applicants to include reviewing each case annually thereafter for continued eligibility. Associated tasks also include monitoring and managing the ACT 421 email to include correspondence with Central Office and Medicaid as needed and maintaining updated forms/policies, maintaining the information in the share drive, completing quarterly updates to Central office, maintaining billing invoices, and maintaining information in the Participant Database.

+ Incumbent has routine interaction with Statistical Resource Institute (state data contract agency) to review and respond to any area of concerns regarding billing/documentation for home and community-based waiver services and/or registry date information discrepancy for services requested.

+ Conduct annual monitoring reviews at contracted Support Coordination Agencies to ensure the agency meets guideline standards set in the Medicaid Case Management Provider manual and to ensure services are provided and documented appropriately. Involves review of recipient records, on-site visits at recipient’s home, assessment of provider compliance with standards, and quality of service delivery.

+ Assist BHSF Waiver Monitoring Unit by providing any and all documentation for survey materials as requested.

+ Incumbent will provide information, training and technical assistance to Support Coordinators, Service Provider Agencies and individuals/families in regard to home and community-based waiver supports and services when requested.

+ Incumbent completes quarterly Level of Care/Plan of Care (LOC/POC) monitoring by completing record reviews of waiver recipients to ensure staff accountability, proper implementation of waiver policies and procedures and determine compliance with guidelines outlined is state and federal Medicaid policy and procedures.

+ Incumbents participate in emergency preparedness training, shelter duties, and activities as assigned by supervisor.

+ Incumbent performs additional duties as assigned by supervisor.

Position-Specific Details:

Appointment Type: This position may be filled by a probational appointment.

Compensation: Note regarding the advertised pay range: The advertised maximum amount listed is the maximum salary a person can make while in this title/level over their career and not the maximum amount we are allowed to pay a new hire.

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 this job title must be included in the application (i.e., relevant, detailed experience/education). Resumes will notbe accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.

Contact Information:

For further information about this vacancy, contact:

Central Louisiana Human Services District

5411 Coliseum Blvd.

Alexandria, La 71303

[email protected]

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

ADi: Rate your ability to accept direction based on our definition: The ability to accept and follow directions from those higher in the chain of command. 1= I have no experience and/or am uncomfortable accepting direction 2= I have limited experience or require assistance to accept direction 3= I can accept direction 4= I can accept directions and help others improve their ability to accept direction

02

ADi: Explain your rating by providing specific and relevant examples in the box below.

03

FC: Rate your ability to focus on customers based on our definition: The ability to serve the needs of those who support and/or rely on the services provided. 1= I have no experience and/or am uncomfortable focusing on customers 2= I have limited experience or require assistance to focus on customers 3= I can focus on customers 4= I can focus on customers and help others improve their ability to focus on customers

04

FC: Explain your rating by providing specific and relevant examples in the box below.

05

FPP: Rate your ability to follow policies and procedures based on our definition: The ability to comply with policies and procedures of the organization as well as State Civil Service rules, and all applicable federal and state laws. 1= I have no experience and/or am uncomfortable following policies and procedures 2= I have limited experience or require assistance to follow policies and procedures 3= I can follow policies and procedures 4= I can follow policies and procedures and help others improve their ability to follow policies and procedures

06

FPP: Explain your rating by providing specific and relevant examples in the box below.

07

WS: Rate your ability to work safely based on our definition: The ability to maintain safety by following rules and procedures. 1= I have no experience and/or am uncomfortable working safely 2= I have limited experience or require assistance to work safely 3= I can work safely 4= I can work safely and help others improve their ability to work safely

08

WS: Explain your rating by providing specific and relevant examples in the box below.

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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