MEDICAID ANALYST 1-3 (Region 6 Rapides)

State of Louisiana; Alexandria (LA); On-site; USD 47,051,000 - 60,948,000; Full time

Job summary

Louisiana Department of Health is seeking a Medicaid Analyst to develop expertise in Medicaid policy and eligibility determination. The role involves processing applications received electronically, by mail, email, in person, or by phone in a high-volume call center environment.

The analyst will work independently, be detail-oriented, and communicate clearly with applicants and colleagues. This position offers a pathway for career growth within the health insurance field and requires strong

Qualifications

• Three years of social services experience; OR Six years of full-time experience in any field; OR a bachelor's degree.
• 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.
• Experience with high call volumes and excellent customer service skills.
• Competency with web-based programs and systems used for Medicaid policy and eligibility determinations.

Responsibilities

• Acquire extensive knowledge of Medicaid policy and procedures and apply tools to determine eligibility.
• Determine eligibility for health insurance for members and applicants via multiple channels.
• Conduct interviews and verify information to determine eligibility for Medicaid programs.
• Interpret and apply complex federal, state, and agency policies to each program.
• Conduct investigations and compliance checks relating to fraud or missing information.

Skills

Customer service

Detail oriented

Team player

Computer literacy

High call volumes

Education

Bachelor's degree

Job description

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 with 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.

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.

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.

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

Job 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 Filed Operations - Region 6 / Rapides Parish

Appointment Type

This position may be filled as a Probationary appointment, Promotional appointment, or Job appointment (temporary appointment that may last up to 48 months).

Cost Center

3052050407

Position Number(s)

Multiple

Career Progression

This position may be filled as a Medicaid Analyst 1, 2, or 3, determined by the qualifications of the candidate selected. This position provides the opportunity to advance within this job series.

Compensation

• 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

paula.jackson@la.,gov

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.

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

• 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 increases.

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