MEDICAID LTC ANALYST 1

Grambling State University; Opelousas (LA); On-site; USD 41,511,000 - 59,122,000; Full time

Job summary

Louisiana Department of Health is seeking an entry‑level Medicaid Long-Term Care Analyst in Louisiana. You will learn to determine financial and medical eligibility for institutionalized care, whether at home or in a facility, while interpreting complex policies and reviewing vital documentation.

The role involves interviewing applicants, examining medical certifications, and coordinating with providers and legal representatives.

Qualifications

• Three years of experience in eligibility determinations for long‑term care programs; 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.

Responsibilities

• Learn to determine financial and medical eligibility for Medicaid Long-Term Care programs for institutionalized individuals, including those in facilities or receiving services at home, by applying federal, state, and agency policies.
• Review and evaluate financial, medical, and case documentation to assess eligibility, resolve discrepancies, obtain required verifications, and request additional documentation as needed.
• Schedule and conduct interviews with applicants, authorized representatives, and facilities to gather information necessary for Long-Term Care eligibility determinations.
• Analyze provider forms and medical certifications to ensure consistency with eligibility requirements, resolving discrepancies related to medical evidence, hardship considerations, penalty periods, and allowable deductions.
• Determine and reconcile recipient financial liabilities, including incurred medical expenses and other deductions that impact provider payments.
• Manage assigned tasks within LaMeds by tracking workloads, analyzing task reports, maintaining required spreadsheets, ensuring applications and renewals are completed within established timeframes, participating in required training, and performing other duties as assigned in support of Eligibility Field Operations.

Skills

Eligibility determinations

Policy interpretation

Interviewing

Critical thinking

Decision making

Adaptability

Effective communication

Customer focus

Policy compliance

Problem solving

Education

Bachelor's degree

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

As a Medicaid Long-Term Care (LTC) Analyst, you’ll learn how to determine financial and medical eligibility for individuals needing institutionalized care—either at home or in a facility. In this entry-level role, you'll gain hands‑on experience interpreting complex policies, reviewing vital documentation, conducting interviews, and working with a wide range of professionals—from healthcare providers to legal representatives.

If you're detail-oriented, eager to learn, and passionate about helping others, this is your opportunity to grow while making a real difference in people’s lives.

An ideal candidate should possess the following competencies:

• Accepting Direction: The ability to be open and willing to follow guidance or instructions.
• Learning Actively: The ability to pursue learning, seek feedback, and integrate new knowledge to improve personal and professional performance.
• Thinking Critically: The ability to analyze information objectively, identify connections across sources, and form logical, well-supported conclusions.
• Acting Decisively: The ability to make timely, confident decisions using sound reason.
• Adapting to Change: The ability to demonstrate flexibility in thoughts, behaviors, and actions in response to evolving circumstances or unexpected change.
• Communicating Effectively: The ability to convey information, ideas, and emotions using structured communication methods that promote understanding and engagement.
• Displaying Expertise: The ability to demonstrate specialized knowledge, skills, and experience to apply subject‑matter expertise in diverse and evolving contexts.
• Focusing on Customers: The ability to understand and meet the needs, preferences, and experiences of internal and external customers.
• 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.
• Solving Problems: The ability to identify root causes, analyze relevant data, and apply practical or innovative solutions to challenges.

Requirements

• Three years of experience in eligibility determinations for long‑term care programs; 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.

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

Job Duties

• Learn to determine financial and medical eligibility for Medicaid Long-Term Care programs for institutionalized individuals, including those in facilities or receiving services at home, by applying federal, state, and agency policies.
• Review and evaluate financial, medical, and case documentation to assess eligibility, resolve discrepancies, obtain required verifications, and request additional documentation as needed.
• Schedule and conduct interviews with applicants, authorized representatives, and facilities to gather information necessary for Long-Term Care eligibility determinations.
• Analyze provider forms and medical certifications to ensure consistency with eligibility requirements, resolving discrepancies related to medical evidence, hardship considerations, penalty periods, and allowable deductions.
• Determine and reconcile recipient financial liabilities, including incurred medical expenses and other deductions that impact provider payments.
• Manage assigned tasks within LaMeds by tracking workloads, analyzing task reports, maintaining required spreadsheets, ensuring applications and renewals are completed within established timeframes, participating in required training, and performing other duties as assigned in support of Eligibility Field Operations.

Position-Specific Details

• Location: Medical Vendor Administration / Eligibility Field Operations-Region 4 / St. Landry Parish
• Appointment Type: This position may be filled as a Probationary appointment, Promotional appointment, Job appointment (temporary appointment that may last up to 48 months)
• Cost Center: 305-2050405
• Position Number(s): Multiple
• 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 LTC Analyst 1 - $17.56 hourly / $ 1,404.80 bi-weekly

Contact Information

• [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 the 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.