Medicaid Analyst 1-3 (Region 2 East Baton Rouge)

State of Louisiana; Baton Rouge (LA); Sur place; USD 34 000 - 44 000; Plein temps

Résumé du poste

The Louisiana Department of Health is seeking a Medicaid Analyst (MA) to acquire in-depth knowledge of Medicaid policy and procedures and apply these tools to determine eligibility for health insurance across multiple access points including online, mail, email, and telephone. The role involves a mix of sedentary computer work and call-center communications with a focus on accuracy and timeliness.

Ideal candidates possess strong communication, accountability, and the ability to follow complex

Qualifications

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

Responsabilités

• Under close supervision, the Medicaid Analyst learns to perform the following duties.
• Makes eligibility determinations for Medicaid programs using the required policies and procedures.
• Interviews clients and verifies information for eligibility determinations.
• Interprets complex federal, state, and agency policies to apply to each program.
• Conducts investigations and compliance reviews related to eligibility and fraud, when needed.

Connaissances

Customer service

Detail oriented

Team player

Communication

Formation

Bachelor's degree

Outils

Web-based programs

Description du poste

About This Job

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

The Medicaid Analyst (MA) is a position responsible for acquiring an extensive knowledge of Medicaid policy and procedures, and using the same tools to make timely and accurate Medicaid eligibility determinations.

The MA determines eligibility for health insurance to members and applicants in the manner of their choosing. The applications are received electronically by computer, by mail, by email, in person, or most often by telephone. This position requires competency of web-based programs. Work conditions are a combination of sedentary work on a computer and helping members by phone in a Call-Center format.

The successful candidate is an individual who works independently, is detail-oriented, has excellent customer service skills, can perform routine activities, is attentive to deadlines, is computer literate, is a team player, and has experience with high call volumes.

Medicaid eligibility is fundamental to the overall Medicaid program, and mastery of eligibility policy and procedure may be the first step in a path for career growth in the health insurance field.

An Ideal Candidate Should Possess The Following Competencies:

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

Demonstrating Accountability: The ability to take ownership of actions, behaviors, performance, decisions, and outcomes.

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.

Minimum Qualifications

• 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 Specification

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Job Duties

Under close supervision, the entry-level Medicaid Analyst learns to perform the following duties:

• The Medicaid Analyst (MA) is a position responsible for acquiring an extensive knowledge of Medicaid policy and procedures and using the same tools to make timely and accurate Medicaid eligibility determinations.
• The MA determines eligibility for health insurance to members and applicants in the manner of their choosing. The applications are received electronically by computer, by mail, by email, in person, or most often by telephone.
• Medicaid eligibility is fundamental to the overall Medicaid program, and the mastery of eligibility policy and procedure may be the first step in a path for career growth in the health insurance field.
• Conducts interviews with clients and makes other necessary collateral contacts for verification in determining eligibility for Medicaid Programs. Examines application packets for timelines, completeness, and appropriateness prior to authorization of reimbursements.
• Makes decisions on complex eligibility factors and determines level of benefits for federal and state funded programs as a result of the roll down procedure. Interprets and applies complex federal, state, and agency policies for each program.
• Conducts special investigations and compliance reports concerning fraud and location of absent parents. Counsels and refers potentially eligible recipients or applicants to other agencies.

Position-Specific Details

Location: Medical Vendor Administration / Eligibility Field Operations - Region 2 / East Baton Rouge Parish

Appointment Type: Probational, Promotional or Job Appointment (temporary appointment that may last up to 48 months)

Cost Center: 305-2050403

Position Number(s): Multiple

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

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.

Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through 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 at https://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 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

Competency Assessment Scoring Method

CE: Communicating Effectively - How well do you share information and ideas in ways that others can understand, relate to, and act on?

• I communicate unclearly, use poor tone, and ignore the audience.
• I share main ideas clearly and adapt to the audience when reminded.
• I communicate clearly, listen actively, and explain complex ideas well.
• I craft messages that connect, inspire, and drive action across audiences.

CE: Communicating Effectively - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.

DA: Demonstrating Accountability - How well do you take responsibility for your actions, results, and performance?

• I avoid responsibility, deliver poor work, and resist feedback.
• I take ownership when prompted and meet basic expectations.
• I own results, meet standards, and respond to feedback professionally.
• I drive high performance, prevent issues, and model accountability.

DA: Demonstrating Accountability - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.

FPP: Following Policies and Procedures - How well do you apply rules, policies, and procedures in your work?

• I struggle to follow rules or apply policies correctly, which can lead to confusion or mistakes.
• I follow rules with support and help correct issues, but I sometimes apply policies inconsistently.
• I apply and explain policies accurately, adapt to routine situations, and help improve procedures.
• I guide others in applying policies, prevent compliance issues, and improve procedures based on experience.

FPP: Following Policies and Procedures - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.

Do you have any previous experience in high call volume settings? If yes, please detail your previous experience. Please type “N/A” for no experience.

To ensure compliance with LDH Nepotism Policy#41, if you have any immediate family members that are currently employed by LDH, please list the name and relationship. Please type “N/A” if no immediate family members are employed by LDH.

Required Question