Medicaid Program Monitor

LDH-Medical Vendor Administration; Baton Rouge (LA); On-site; USD 55,000 - 75,000; Full time

Job summary

Louisiana Department of Health is seeking a Program Monitor to lead provider monitoring efforts, review financial and compliance records, and conduct on-site assessments. The role collaborates with partners to ensure accountability and regulatory compliance and to safeguard Medicaid funding for Louisiana nursing home residents.

The position emphasizes audit readiness, data reconciliation, and cross-team coordination to support policy updates and training initiatives.

Qualifications

• Six years of experience in developing, managing, or evaluating health or social service programs.
• Six years of full-time work experience in any field plus three years in health programs.
• Bachelor’s degree plus three years in health program management.
• Advanced degree or JD plus two years in health program management.
• Experience substitution: hours earned can substitute for experience.

Responsibilities

• Oversees provider monitoring activities for Medicaid program requirements.
• Conducts desk reviews and on-site monitoring visits.
• Reviews cost reports and financial records for accuracy and compliance.
• Identifies deficiencies and coordinates corrective action plans.
• Prepares compliance reports and audit-ready records.
• Collaborates with fiscal, audit, and program teams to reconcile data.
• Monitors program performance and safeguards Medicaid funding.

Skills

Experience in health programs

Public health / health regulation

Review and oversight experience

Data reconciliation

Education

Bachelor's degree in health or related field

Advanced degree or JD in health/public policy

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

Are you detail-oriented and passionate about ensuring quality healthcare services? Join our team as a Program Monitor and play a critical role in safeguarding Medicaid-funded programs! In this position, you’ll lead provider monitoring efforts, review financial and compliance records, conduct on-site assessments, and collaborate with partners to ensure accountability and regulatory compliance. Your work will help protect essential healthcare funding, strengthen program integrity, and ensure Louisiana nursing home residents continue to receive the services they need. Apply today and make an impact!

Experience Qualifications:

• Six 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 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; OR
• A bachelor’s degree 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; OR
• An advanced degree or a Juris Doctorate plus two 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.

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

Job Duties:

• Oversees provider monitoring activities to ensure compliance with Medicaid program requirements, state and federal regulations, and established policies.
• Conducts desk reviews and on-site monitoring visits to evaluate provider performance, operational practices, and compliance standards.
• Reviews cost reports, financial records, and supporting documentation to verify accuracy, completeness, and compliance with reporting and reimbursement requirements.
• Identifies compliance deficiencies, investigates discrepancies, and coordinates corrective action plans with providers to address findings.
• Prepares compliance reports, monitoring summaries, and supporting documentation while maintaining accurate, audit-ready records.
• Collaborates with fiscal, audit, and program teams to reconcile data, resolve compliance issues, and support policy updates and training initiatives.
• Monitors program performance and provider accountability to safeguard Medicaid funding, maintain audit readiness, and support the delivery of essential services to Louisiana nursing home residents.

Position-Specific Details:

Location: Medical Vendor Administration / Rate Setting and Audit / East Baton Rouge Parish

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

Cost Center: 3052120201

Position Number(s): 50375592

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.