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
Are you passionate about improving healthcare services and ensuring quality care for those who need it most? As a Medicaid LTC Specialist, you'll play a vital role in analyzing provider data, resolving eligibility issues, and supporting program integrity in Long-Term Care. Use your expertise to research complex cases, ensure policy compliance, and collaborate across teams to drive continuous improvement. If you're detail-oriented, love solving problems, and want to make a real impact in Medicaid services, we encourage you to apply today!
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.
Making Accurate Judgments: The ability to assess options, weigh risks, and make sound decisions using available information and logical reasoning.
Thinking Critically: The ability to analyze information objectively, identify connections across sources, and form logical, well supported conclusions.
Minimum Qualifications
Six years of experience in eligibility determinations for long-term care programs; OR
Six years of full-time experience in any field plus three years of experience in eligibility determinations for long-term care programs; OR
A bachelor's degree plus three years of experience in eligibility determinations for long-term care programs; OR
An advanced degree plus two years of experience in eligibility determinations for long-term care programs.
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 Specification
The official job specifications for this role, as defined by the State Civil Service, can be found here.
Job Duties:
Job Duties and Other Information
- Act as a liaison with the fiscal intermediary and Medicaid Eligibility Systems to address recipient and provider service/payment discrepancies and recommend sanctions when necessary.
- Perform special studies, analyze data, and complete reports to ensure program integrity and accuracy in Long-Term Care eligibility.
- Conduct ongoing programmatic reviews to ensure compliance with federal and state regulations, collaborating with IT staff to maintain accurate policy reflection in systems.
- Participate in Medicaid policy and procedure training, as well as provider outreach and emergency preparedness activities.
- Assist in training LTC staff and support continuous quality improvement initiatives using methodologies like WorkSmart, Agile, and Lean Six Sigma.
Position-Specific Details:
Location: Medical Vendor Administration / Eligibility Field Operations/ St. Landry Parish
Appointment Type: This is a
promotional opportunity open only to current permanent employees in a
classified position with Louisiana Department of Health, Medical Vendor Administration.
Cost Center: 2050405
Position Number(s): 50603359
Compensation: This position is eligible for the following Special Entrance Rates (SER), as well as a Premium Pay of up to $2.00/hr for hours worked based on longevity. Medicaid LTC Specialist - $24.35 hourly / $1,948.00 bi-weekly
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.
Contact Information:
Shambrielle Pooler
Shambrielle.Pooler@la.gov
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.
Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to
make a difference through public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career.
As a State Employee, You Will Earn Competitive Pay, Choose From a Variety Of Benefits, And Have Access To a Great Professional Development Program:
Insurance Coverage More information can be found at https://info.groupbenefits.org/
Parental Leave – Up to six weeks paid parental leave
More information can be found at https://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx
Holidays and Leave – State employees receive the following paid holidays each year:
- New Year's Day
- Martin Luther King, Jr. Day,
- Mardi Gras,
- Good Friday,
- Memorial Day,
- Independence Day,
- Labor Day,
- Veteran's Day,
- Thanksgiving Day and Christmas Day.
- Additional holidays may be proclaimed by the Governor
State employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.
Retirement – State Of Louisiana Employees Are Eligible To Participate In Various Retirement Systems (based On The Type Of Appointment And Agency For Which An Employee Works). These Retirement Systems Provide Retirement Allowances And Other Benefits For State Officers And Employees And Their Beneficiaries. State Retirement Systems May Include (but Are Not Limited To):
- Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video to give you more detailed information about their system
- Teacher's Retirement System of Louisiana (www.trsl.org),
- Louisiana School Employees Retirement System (www.lsers.net), among others
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Are you a current permanent employee in a classified position with Louisiana Department of Health - Medical Vendor Administration?
02
To ensure compliance with LDH Nepotism Policy#41, if you have any immediate family members that are currently employed by LDH, please list the name and relationship. Please type “N/A” if no immediate family members are employed by LDH.
03
CE - 26: Communicating Effectively - How well do you share information and ideas in ways that others can understand, relate to, and act on?
- I communicate unclearly, use poor tone, and ignore the audience.
- I share main ideas clearly and adapt to the audience when reminded.
- I communicate clearly, listen actively, and explain complex ideas well.
- I craft messages that connect, inspire, and drive action across audiences.
04
CE - 26: Communicating Effectively - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.
05
MAJ - 26: Making Accurate Judgments - How do you make decisions when faced with choices, risks, or limited information?
- I make reactive or delayed decisions and sometimes overlook risks, priorities, or potential bias.
- I try to weigh options but struggle when there’s uncertainty, competing priorities, or unclear outcomes.
- I make timely, well-reasoned decisions by using available information, context, and trade-offs.
- I make sound decisions in complex situations, lead others through ambiguity, and adapt as new information emerges.
06
MAJ - 26: Making Accurate Judgments - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.
07
TCr - 26: Thinking Critically - How do you analyze information and draw meaningful conclusions from it?
- I miss key details or oversimplify information, and my conclusions may not be based on evidence.
- I try to analyze information, but I may overlook the relevance or credibility of my sources.
- I analyze key information, consider the evidence, and form logical conclusions based on credible sources.
- I uncover deeper insights by connecting different sources, questioning assumptions, and identifying patterns.
08
TCr - 26: Thinking Critically - Explain your selection by providing specific examples from your experience. Tip: Use the STAR method (situation, task, action, result) to explain how you have demonstrated this competency. Examples from work, military service, volunteering, education, or other life experiences are all valid.
