Medicaid Program Manager 1-A

LDH-Medical Vendor Administration; Baton Rouge (LA); On-site; USD 65,000 - 90,000; Full time

Job summary

Louisiana Department of Health is seeking a skilled program leader to manage the Medicaid Evidence-based Decisions program and advance statewide quality initiatives. You will guide performance measures, provide technical support to MCOs, and act as a bridge between Quality and Clinical Policy teams to support evidence-based practice.

You will collaborate with Healthy Louisiana staff on Clinical Quality Measures, contribute to MCIP administration, and drive policy-informed manuscripts and briefs

Qualifications

• Seven years of experience developing, managing, or evaluating health or social service programs.
• Six years of full-time work experience in any field plus four years in health or social service programs.
• Bachelor’s degree plus four years in health/public health program management.
• An advanced degree or JD plus three years in health or social service program management.
• EXPERIENCE SUBSTITUTION: Every 30 semester hours credits one year experience, up to four years substitute.

Responsibilities

• Manages the Medicaid Evidence-based Decisions (MED) program in compliance with contract deliverables.
• Assists in the development and management of performance measures related to Medicaid and the MCOs.
• Provides technical assistance to MCOs in adhering to program policies and contract deliverables.
• Serves as liaison between Quality and Clinical Policy teams to support evidence-based practice.
• Collaborates with Healthy Louisiana staff on Clinical Quality Measures (CQM).
• Assists with administration of the Managed Care Incentive Program (MCIP).
• Implements quality improvement initiatives by data analysis, literature review, and policy development.
• Monitors statewide operations to assess efficiency and effectiveness of service delivery.
• Assists with development and review of MCO contract deliverables.

Skills

Health program management

Data analysis

Policy research

Stakeholder communication

Education

Bachelor's degree

Advanced degree or JD

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 Louisiana Department of Health

Make a statewide impact on the quality of healthcare for Louisiana Medicaid members! Join LDH’s Medicaid Quality Improvement team and lead innovative quality improvement initiatives that use data, evidence-based practices, and technology to improve access and outcomes for nearly 1.7 million Medicaid enrollees. As a key program leader, you’ll help shape statewide quality programs, drive meaningful improvements in healthcare delivery, and turn data into action that makes a difference for Louisiana communities.

• Seven years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
• Six years of full-time work experience in any field plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
• A bachelor’s degree plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR
• An advanced degree or a Juris Doctorate plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.
• 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

• Manages the Medicaid Evidence-based Decisions (MED)program in compliance with contract deliverables.
• Assists in the development and management of performance measures as related to Medicaid and the MCOs.
• Provides technical assistance to MCOs in adhering to program policies and contract deliverables that guide program outcomes.
• Serves as a liaison between the Quality team and the Clinical Policy team to utilized at inform programmatic efforts to support evidence-based practice.
• Serves as a liaison for Medicaid Program Manager 2 in collaborating with Healthy Louisiana staff on Clinical Quality Measures (CQM).
• Assists with the administration of the Managed Care Incentive Program(MCIP).
• Implements quality improvement initiatives by analyzing data, conducting literature searches and researching policies, and evidence-based practices to develop manuscripts, fact sheets and policy briefs in direct response to legislative requests.
• Monitorsstatewide operations to determine efficiency and effectiveness of the delivery ofservices.
• Assists with the development and review of Managed Care Organization(MCO) contract deliverables

Position-Specific Details

Location: Medical Vendor Administration / Quality Improvement and Innovations / East Baton Rouge Parish

Appointment Type: This position may be filled as a Probationary appointment, Promotional appointment, or Detail to Special Duty

Cost Center:3052030601

Position Number(s):50558650

Contact Information

Shambrielle Pooler

[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.