Medicaid Policy & Appeals Specialist

State of Louisiana; Baton Rouge (LA); On-site; USD 60,000 - 95,000; Full time

Job summary

Louisiana Department of Health in Baton Rouge is seeking a qualified professional to join the Office of Aging and Adult Services. The role focuses on developing and revising policies, coordinating rulemaking, and overseeing OAAS Medicaid waiver programs to support older adults and individuals with disabilities.

Applicants should have a current Louisiana license or appropriate degree with relevant experience, along with strong analytical and collaborative skills to improve program operations and

Qualifications

• Current Louisiana license in a health services field, health regulation field, or social services field plus two years of relevant experience.
• Bachelor's degree plus two years of experience in hospital or nursing home administration, health services, health regulation, or social services.
• Master's degree in a health services, health regulation, or social services field plus one year of related experience.

Responsibilities

• Develop, review, and revise policies, procedures, applications, renewals, amendments, and state plan amendments for OAAS Medicaid waiver and state plan programs.
• Coordinate policy development and rulemaking to ensure compliance with state and federal laws and Medicaid requirements.
• Administer and oversee statewide appeals processes for OAAS programs, including LT-PCS, CCW, ADHC, and PACE.
• Review and analyze appeal requests, supporting docs, coordinate hearings, and represent OAAS at administrative hearings when needed.
• Develop and maintain appeals policies, procedures, manuals, forms, and training materials for consistent statewide implementation.

Job description

Louisiana Department of Health in Baton Rouge is seeking a qualified professional to join the Office of Aging and Adult Services. The role focuses on developing and revising policies, coordinating rulemaking, and overseeing OAAS Medicaid waiver programs to support older adults and individuals with disabilities.

Applicants should have a current Louisiana license or appropriate degree with relevant experience, along with strong analytical and collaborative skills to improve program operations and