MEDICAID ANALYST 1-3

Nunez Community College; Alexandria (LA); On-site; USD 32,000 - 42,000; Full time

Job summary

The Louisiana Department of Health is hiring for Medicaid Analyst roles focused on eligibility determination, policy interpretation, and system training. The position involves utilizing LaMEDS to process applications, verify eligibility, and provide applicant counseling within federal and state timelines.

The role offers a probationary or promotional classified appointment in the LDH, with opportunities for career progression across Medicaid Analyst levels and related program areas.

Qualifications

• Three years of social services experience; OR
• Six years of full-time experience in any field; OR
• A bachelor's degree.

Responsibilities

• Maintains working knowledge of Medicaid programs, eligibility criteria, and policies to accurately determine eligibility for federally and state-funded Medicaid programs using LaMEDS.
• Reviews and validates Medicaid eligibility determinations, including decision letters and benefit information, and processes required updates to applicant and recipient information.
• Processes applications, case changes, retroactive coverage requests, reimbursements, manual notices, and other Medicaid-related requests in accordance with applicable policies and procedures.
• Counsels applicants and recipients regarding Medicaid eligibility, covered services, available resources, and application requirements, and provides referrals to appropriate governmental agencies and community programs.
• Utilizes LaMEDS and related reporting tools to monitor application assignments, verify eligibility information, and ensure initial and renewal applications are completed within established federal and state timeframes.
• Interprets and applies complex federal, state, and agency policies and procedures; analyzes eligibility issues and system-generated decisions; and recommends procedural updates as appropriate.
• Participates in Medicaid policy, procedure, and systems training and quality improvement initiatives, while completing outreach, emergency preparedness, and other assigned activities.

Skills

Communicating effectively

Following policies and procedures

Making accurate judgments

Accepting direction

Acting decisively

Acting with ethics & integrity

Adapting to change

Demonstrating initiative

Managing time

Solving problems

Education

Bachelor's degree

Tools

LaMEDS

Job description

The mission of the Louisiana Department of Health is to protect and promote health and to ensure access to medical, preventive, and rehabilitative services for all residents of the State of Louisiana.

Learn more about the Louisiana Department of Health

Make a meaningful impact on Louisiana Medicaid! Join the Special Operations and Supports team and play a key role in strategic eligibility and enrollment activities, special projects, and initiatives that directly support Medicaid clients. This position offers the opportunity to apply your analytical skills, Medicaid knowledge, and problem-solving abilities while helping ensure important projects are completed accurately and efficiently. If you’re ready to make a difference and be part of a team that supports access to vital healthcare services, we encourage you to apply!

Communicating Effectively

The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.

Following Policies and Procedures

The ability to follow, reinforce, adapt, or develop policies and procedures to maintain compliance with federal and state legal requirements, State Civil Service rules, and organizational policies.

Making Accurate Judgments

The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.

Accepting Direction

The ability to be open and willing to follow guidance or instructions.

Acting Decisively

The ability to make timely, confident decisions using sound reason.

Acting with Ethics and Integrity

The ability to make choices that reflect ethical standards, integrity and honesty, regardless of circumstances or personal benefit.

Adapting to Change

The ability to demonstrate flexibility in thoughts, behaviors, and actions in response to evolving circumstances or unexpected change.

Demonstrating Initiative

The ability to assess situations independently and take proactive steps to address them without being prompted or instructed by others.

Managing Time

The ability to prioritize tasks, meet deadlines, and allocate time to ensure timely completion of work goals.

Solving Problems

The ability to identify root causes, analyze relevant data, and apply practical or innovative solutions to challenges.

Experience Requirements

• Three years of social services experience; OR


• Six years of full-time experience in any field; OR


• A bachelor's degree.

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 Duties

• Maintains working knowledge of Medicaid programs, eligibility criteria, and policies to accurately determine eligibility for federally and state-funded Medicaid programs using LaMEDS.


• Reviews and validates Medicaid eligibility determinations, including decision letters and benefit information, and processes required updates to applicant and recipient information.


• Processes applications, case changes, retroactive coverage requests, reimbursements, manual notices, and other Medicaid-related requests in accordance with applicable policies and procedures.


• Counsels applicants and recipients regarding Medicaid eligibility, covered services, available resources, and application requirements, and provides referrals to appropriate governmental agencies and community programs.


• Utilizes LaMEDS and related reporting tools to monitor application assignments, verify eligibility information, and ensure initial and renewal applications are completed within established federal and state timeframes.


• Interprets and applies complex federal, state, and agency policies and procedures; analyzes eligibility issues and system-generated decisions; and recommends procedural updates as appropriate.


• Participates in Medicaid policy, procedure, and systems training and quality improvement initiatives, while completing outreach, emergency preparedness, and other assigned activities.

Position-Specific Details

Location: Medical Vendor Administration / Eligibility Field Operations / Rapides Parish

Appointment Type: Probational or Promotional appointment of a classified LDH employee.

Cost Center: 305-2050400

Position Number(s): 50380810 & 50301086

Career Progression: This position may be filled as a Medicaid Analyst 1, 2, or 3, depending on the qualifications of the selected applicant.

Compensation

This position is eligible for the following Special Entrance Rates (SER), as well as a Premium Pay of up to $2.00/hr for hours worked based on longevity.

• Medicaid Analyst 1 - $16.42 hr / $1,313.60 bi-weekly


• Medicaid Analyst 2 - $17.56 hr / $1,404.80 bi-weekly


• Medicaid Analyst 3 – $21.27 hr / $1,701.60 bi-weekly

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

Contact Information

Paula Jackson

[e-mail]

LA Department of Health (LDH)

Division of Human Resources

PO Box 4818

Baton Rouge, LA 70821

225-342-6477

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

LDH supports Louisiana’s commitment to being a State as a Model Employer (SAME) by promoting the recruitment, hiring, and retention of individuals with disabilities.

Information on Louisiana Works, Louisiana Rehabilitation Services is available here.

LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.