Medical Certification Specialist 1-2

About this Job

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

This position may be filled in the following parish(es): East Baton Rouge

Make a meaningful impact on the lives of Louisianas older adults and individuals with disabilities! Join the Office of Aging and Adult Services (OAAS) and help strengthen programs that provide essential long-term care and support services. This position reports to work in-person to the Bienville Building 5 days per week and works directly under the supervision of the OAAS Policy Development Level of Care Medical Certification Manager 2. Be part of a team dedicated to expanding choices promoting quality care and helping individuals maintain their independence dignity and quality of life.

Apply today and help build a stronger more supportive future for Louisianas communities!

Minimum Qualifications

A current Louisiana license in a health services field health regulation field or social services field plus two years of experience in hospital or nursing home administration health services health regulation or social services; OR

A bachelors degree plus two years of experience in hospital or nursing home administration health services health regulation or social services; OR

A masters degree in a health services field health regulation field or a social services field plus one year of experience in hospital or nursing home administration health services health regulation or social services.

Job Specification

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

Job Duties and Other Information

Job Duties:

The following provides a brief overview of the positions primary responsibilities and is not intended to be an exhaustive list of all duties and assignments.

• 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 activities to ensure compliance with applicable state and federal laws regulations and Medicaid requirements.
• Administer and oversee statewide appeals processes for OAAS programs including LT-PCS CCW ADHC and PACE ensuring compliance with established procedures and deadlines.
• Review and analyze appeal requests supporting documentation and evidence; coordinate hearings resolve issues and represent OAAS at administrative hearings as needed.
• Develop and maintain appeals policies procedures manuals forms and training materials to support consistent statewide implementation.
• Provide technical assistance guidance and subject matter expertise to OAAS staff contractors and stakeholders regarding program requirements appeals and compliance.
• Monitor appeals activities contractor performance service authorizations and program reports to identify operational issues and recommend corrective actions.
• Evaluate program operations address audit findings and collaborate with management to implement policy revisions and quality improvement initiatives.
• Oversee program documentation and operation systems while ensuring compliance with federal regulations CMS requirements and LDH policies.
• Prepare reports and recommendations for management and governmental entities participate in special projects and perform other duties as assigned.
• Adhere to applicable laws rules regulations policies and procedures of LDH OAAS Civil Service and appropriate state/federal licensing and governing bodies.
• Participate in special projects as needed as well as performs other duties assigned by supervisors for smooth and effective operation of the agency and of the OAAS programs.
• Work in the OAAS state office Monday-Friday during business hours to ensure team collaboration and operational needs.

Position-Specific Details:

Location: Office of Aging and Adult Services / AD POLICY DEVELOPMENT-SO / East Baton Rouge Parish

Appointment Type: This position may be filled as a Probationary appointment or Promotional appointment

Cost Center:

Position Number(s): 135102

Career Progression: This position may be filled as a Medical Certification Specialist 1 or 2 determined by the qualifications of the candidate selected. This position provides the opportunity to advance within this job series.

Applicants with the following are encouraged to apply:

• A current interRAI-HC certification from OAAS.

• Knowledge of state and federal guidelines and agency policies and procedures in addition to knowledge of the Medicaid service system for Long Term Care and Home and Community-Based Services (HCBS).

• Knowledge of the appeal process to ensure that all appeals are processed in accordance with established requirements and timelines.

How To Apply:

No Civil Service test score is required in order to be considered for this vacancy.

To apply for this vacancy click on the Apply link above and complete an electronic application which can be used for this vacancy as well as future job opportunities. Applicants are responsible for checking the status of their application to determine where they are in the recruitment process. Further status message information is located under the Information section of the Current Job Opportunities page.

* Information to support your eligibility for the position must be included in the application (i.e. relevant detailed experience/education). Resumes will not be accepted in lieu of completed education and experience sections. Applications may be rejected if incomplete.

For information on how to check your application status and understand status updates please click HERE .

Contact Information:

Debbie Parris-Thymes

LA Department of Health (LDH)

Division of Human Resources

PO Box 4818

Baton Rouge LA 70821

This organization participates in E-verify and for more information on E-verify please contact DHS at 1-.

LDH supports Louisianas 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.

Required Experience:

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