Medicaid Program Manager 3(Managed Care Compliance Manager)

Supplemental Information

The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.

LDH serves as a model employer for individuals with disabilities.

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Program Operations and Compliance / East Baton Rouge Parish

Announcement Number: MVA/SP/192399

Cost Center: 3052020600

Position Number: 50562691

This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary or Promotional appointment.

(Job appointments are temporary appointments that may last up to 48 months)

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.

• Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*

A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resumeis not eligible to receive credit

For further information about this vacancy contact:

Shambrielle Pooler

Shambrielle.Pooler@la.gov

LDH/HUMAN RESOURCES

BATON ROUGE, LA 70821

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.

Qualifications

MINIMUM QUALIFICATIONS:

A baccalaureate degree plus five years of professional experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.

SUBSTITUTIONS:

Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.

Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:

A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.

30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.

60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.

90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.

120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.

College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience tosubstitute for the baccalaureate degree.

Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; public relations; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.

A master's degree in the above fields will substitute for one year of the required experience.

A Juris Doctorate will substitute for one year of the required experience.

Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.

A Ph.D. in the above fields will substitute for two years of the required experience.

Advanced degrees will substitute for a maximum of two years of the required experience.

NOTE:

Any college hours or degree must be from an accredited college or university.

Job Concepts

Function of Work:

To direct large and very complex Medicaid program(s).

Level of Work:

Administrator.

Supervision Received:

Administrative direction from a higher-level administrator/executive.

Supervision Exercised:

Supervision over lower-level positions in accordance with the Civil Service Allocation Criteria Memo.

Location of Work:

Department of Health and Hospitals.

Job Distinctions:

Differs from Medicaid Program Manager 2 by responsibility for directing large and highly complex Medicaid program(s) and supervision exercised.

Differs from Medicaid Program Manager 4 by the absence of serving as the Section Chief administrating all functions of large and complex Medicaid program(s) and supervision exercised.

Examples of Work

Administers comprehensive statewide Medicaid programs by formulating and implementing current and long-range plans, policies, procedures and regulations.

Monitors policies and procedures to ensure that policies and system requirements comply with the law and federal regulations.

Participates in overall agency budget planning, preparation, and grant administration.

Works closely with state, regional, and parish administrative staff in developing management procedures and operational plans to assure that all agency programs are implemented at the field operations level as intended by federal and state laws and regulations.

Coordinates with state level administrative and support staff to improve program development, identify staff training needs and provide management and support services required and needed by department staff.

Develops, monitors and administers various methodology reimbursement policies.