MEDICAID PROGRAM SPECIALIST 1-2

Grambling State University; Baton Rouge (LA); Sur place; USD 42 000 - 62 000; Plein temps

Avantages offerts par ce poste

Premium Pay up to $2.00/hr

Bilingual premium up to $2.50/hr

Résumé du poste

Louisiana Department of Health in Baton Rouge seeks a Medicaid Program Specialist who will articulate policy and eligibility to members and providers, manage applications and renewals, and support case updates with empathy and accuracy.

The role emphasizes strong communication, critical thinking, data use, and cultural competency, with a focus on quality service in a public health setting.

Qualifications

• Three years of Medicaid/program analysis experience or six years of general work experience.
• Experience substitutable by 30 semester hours per year; up to 120 semester hours may substitute for four years.

Responsabilités

• Maintains comprehensive knowledge of Medicaid programs, policies, and eligibility systems.
• Interprets and communicates Medicaid eligibility determinations and letters.
• Completes Medicaid applications, renewals, and case updates; handles demographic and income changes.
• Communicates effectively with members, potential members, and providers by phone.
• Applies empathy, problem-solving, active listening, and cultural competency in interactions.

Connaissances

Communicating Effectively

Demonstrating Accountability

Thinking Critically

Using Data

Accepting Direction

Emotional Intelligence

Initiative

Thinking Strategically

Formation

Bachelor's degree

Description du poste

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

Join a team where your expertise and people skills shine. Use your deep knowledge of Medicaid programs to guide members through eligibility, applications, renewals, and case updates-while delivering exceptional service through empathy, critical thinking, and cultural awareness. If you’re passionate about helping others and solving complex challenges, we want you.

An ideal candidate should possess the following competencies:

• 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.
• Thinking Critically: The ability to analyze information objectively, identify connections across sources, and form logical, well-supported conclusions.
• Using Data: The ability to collect, analyze, and use data to generate insights and inform decisions.
• Accepting Direction: The ability to be open and willing to follow guidance or instructions.
• Demonstrating Emotional Intelligence: The ability to identify and understand emotions in oneself and others and use that understanding to manage one's behavior and relationships.
• Demonstrating Initiative: The ability to assess situations independently and take proactive steps to address them without being prompted or instructed by others.
• Thinking Strategically: The ability to anticipate trends, understand context, and align actions with long-term priorities.

• Three years of experience in research and analysis related to Medicaid programs; public health, public relations, social services, health services, or administrative services; OR
• Six years of full-time work 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:

• Maintains an extensive and precise working knowledge of all Medicaid programs, policies and procedures, and eligibility and ancillary systems in order to accurately and effectively communicate Medicaid policy and eligibility with members, potential members, and providers.
• Responsible for employing knowledge of Medicaid eligibility policy and procedure to interpret and communicate eligibility determinations, including decision letters.
• Completes Medicaid applications, completes Medicaid renewals, provides information on case status and Medicaid program coverage, completes requests for duplicate cards, completes requests for case changes such as changes to demographic information and income, adds or removes case members, and reads and interprets case notes and notices.
• Responsible for communicating effectively with members, potential members, and providers by phone.
• Responsible for utilizing soft skills in all interactions, including empathy, problem-solving, patience, active listening, conflict resolution, emotional intelligence, creativity, time management, critical thinking, and social skills. Responsible for understanding and applying cultural competency.

Position-Specific Details:

Location: Medical Vendor Administration / Eligibility Field Operations / East Baton Rouge

Appointment Type: Probational, Job Appointment (temporary appointment that may last up to 48 months), Promotional or Detail appointment of a current classified LDH employee.

Cost Center: 305-2050412

Position Number(s): 50656167

Career Progression: This position may be filled as a Medicaid Program Specialist 1 or 2 depending on the qualifications of the selected applicant.

Compensation: This position is eligible for Premium Pay of up to $2.00/hr for hours worked based on longevity.

Bilingual applicants may be eligible for premium pay up to $2.50 hourly for hours worked only.

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 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 factors.