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Medical Certification Specialist

State of Louisiana

Medical Certification Specialist

Lafayette, LA +2 locations
Full Time
Paid
  • Responsibilities

    Medical Certification Specialist 1-2 Medical Certification Specialist 1-2 Salary $4,141.00 - $7,816.00 Monthly Location Lafayette, LA Job Type Classified Department LDH-Office of Aging & Adult Services Job Number OAAS/AW/0466 Closing 7/1/2018 11:59 PM Central * Description * Benefits Supplemental Information Supplemental Information This position is located within the Louisiana Department of Health / Office of Aging and Adult Services/ Region 4/Lafayette Job Number: OAAS...AW...0466 Cost Center: 320-8641 Position #: 50382940 Job Title: Medical Certification Specialist 1-2 Location: Lafayette Incumbent should demonstrate knowledge of State and Federal Medicaid guidelines and LDH/OAAS rules, policies and procedures in addition to knowledge of the service system for all Home and Community Based programs. As part of a Career Progression Group, vacancies may be filled from this recruitment as a Medical Certification Specialist 1 or 2 depending on the level of experience of the selected applicant(s). The maximum salary for the Medical Certification Specialist 2 is $100,360. Please refer to the 'Job Specifications' tab located at the top of the LA Careers 'Current Job Opportunities' page of the Civil Service website for specific information on salary ranges, minimum qualifications and job concepts for each level. INCOMPLETE APPLICATIONS MAY RESULT IN YOUR APPLICATION BEING REJECTED. RESUMES WILL NOT BE ACCEPTED IN LIEU OF AN APPLICATION. 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 by selecting the 'Applications' link after logging into their account. Below are the most common status messages and their meanings. Application received - Your application has been submitted successfully. Evaluating experience - Your application is being reviewed to ensure you meet the minimum qualifications for the position. Minimum Qualification Review See History Click the History link for the results of your application review. Passing candidates will designate as "Pass". Failing candidates will designate as "Fail". Eligible for consideration - You are among a group of applicants who MAY be selected for the position. Eligible Pending Supplemental Qualification Review - Only candidates meeting the supplemental qualification will be eligible for referral. Referred to hiring manager for review - Your application has been delivered to the hiring manager. You may or may not be called for an interview. Position filled - Someone has been selected for the position. Position canceled - The agency has decided not to fill the position. The State of Louisiana only accepts online applications. Paper applications will not be accepted. Computer access is available at your local library, at local Louisiana Workforce Commission Business Career Solutions Centers (Download PDF reader), and at our Baton Rouge Information and Testing Office at 5825 Florida Boulevard, Room 1070, Baton Rouge, LA 70806. If you require an ADA accommodation, please contact our office at (225) 925-1911 or Toll Free: (866) 783-5462 during business hours for additional assistance. (Please note: Libraries and LWC centers cannot provide in-depth assistance to applicants with limited computer skills; therefore, we suggest that such applicants have someone with computer proficiency accompany them to these facilities to assist with the computer application process. Also, no State Civil Service employees are housed at the libraries or LWC centers to answer specific questions about the hiring process. Such questions should be directed to our Baton Rouge Information and Testing Office at the phone numbers above or by visiting the office on Florida Blvd. where assistance is available. Information is also provided on our job seeker website at www.jobs.la.gov). There is no guarantee that everyone who applies to this posting will be interviewed. The hiring supervisor/manager has 90 days from the closing date of the announcement to make a hiring decision. Specific information about this job will be provided to you in the interview process, should you be selected. For further information about this vacancy contact: Andrell Ward andrell.ward@la.gov Or write to : DHH/HRTSD 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. Qualifications MINIMUM QUALIFICATIONS: A baccalaureate degree plus two years of professional level experience in hospital or nursing home administration, public health administration, social services, nursing, pharmacy, dietetics/nutrition, physical therapy, occupational therapy, medical technology, or surveying and/or assessing health or social service programs or facilities for compliance with state and federal regulations. SUBSTITUTIONS: A current valid Louisiana license in one of the qualifying fields will substitute for the required baccalaureate degree. A master's degree in hospital administration, nursing home administration, public health administration, social work, nursing, pharmacy, dietetics, nutrition, physical therapy, occupational therapy, or medical technology will substitute for a maximum of one year of the required experience. NOTE: Any college hours or degree must be from a school accredited by one of the following regional accrediting bodies: the Middle States Commission on Higher Education; the New England Association of Schools and Colleges; the Higher Learning Commission; the Northwest Commission on Colleges and Universities; the Southern Association of Colleges and Schools; and the Western Association of Schools and Colleges. NOTE: A current valid Louisiana license in an individual field may be required for some positions. Job Concepts FUNCTION OF WORK: To conduct surveys and/or assessments to verify that the services provided to individuals by providers, facilities, waivers, and/or long term care programs are in compliance with federal certification, state regulations, and established state standards. LEVEL OF WORK: Experienced. SUPERVISION RECEIVED: Broad review from Medical Certification Supervisor or other higher level agency administrator. SUPERVISION EXERCISED: None. LOCATION OF WORK: Department of Health and Hospitals. JOB DISTINCTIONS: Differs from Medical Certification Specialist 2 by the absence of Centers for Medicare and Medicaid Services certification and by the level of independence exercised in carrying out work responsibilities. Examples of Work EXAMPLES LISTED BELOW ARE BRIEF SAMPLES OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. PLEASE NOTE THAT NOT ALL TASKS ARE INCLUDED. Conducts surveys of health and social services programs, facilities, and providers that are state licensed and/or certified for state and federal programs. Conducts assessments to ensure receipt of quality services by contracted providers. Studies the facility or other Medicaid enrolled provider relative to quality of medical services to determine the extent of compliance with state/federal regulations, state licensing, or established state standards. Obtains information from review of records, staff interviews, resident interviews, personal observations relative to the operation of the medical facility, compliance standards, and quality of medical care provided. Evaluates equipment and environmental factors of the facility for compliance with federal and state regulations. Compiles information derived from surveys or paid Medicaid claims data and reports findings to recommend whether licensure and/or certification should be granted, denied, deferred, continued, or a change in Medicaid reimbursement is warranted. Conducts special investigations in response to complaints and prepares report findings. Certifies individuals as medically eligible to receive waiver services. Creates and monitors a continuous quality improvement process. Approves waiver recipients' comprehensive plan of care and annually evaluates the overall effectiveness of waiver recipients' comprehensive plan of care. Ensures that personal outcomes resulting from the receipt of waiver services are reflective of the person-centered goals identified in their comprehensive plan of care. Conducts quality assurance of case management agencies and service providers relative to organization, policies and procedures, administration, qualifications of staff and quality of services to determine the extent of compliance with Medicaid regulations and waiver recipients comprehensive plan of care. Evaluates the appropriateness and the quality of medical care based on personal observations, interviews, and/or established state performance standards. Receives, reviews, and determines appropriateness of recipient appeals of denied services. Gathers factual information and prepares summary of evidence. Presents testimony before Administrative Law Judge. Benefits 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. Flexible Working Arrangements The flexibility of our system allows agencies to implement flexible working arrangements through the use of alternative work schedules, telecommuting and other flexibilities. These arrangements vary between hiring agencies. Professional Development - The Comprehensive Public Training Program (CPTP) is the state-funded training program for state employees. Through CPTP, agencies are offered management development and supervisory training, and general application classes on topics as diverse as writing skills and computer software usage. Insurance Coverage Employees can choose one of several health insurance programs ranging from an HMO to the State's own Group Benefits Insurance program. The State of Louisiana pays a portion of the cost for group health and life insurance. Dental and vision coverage are also available. More information can be found at www.groupbenefits.org. Deferred Compensation As a supplemental retirement savings plan for employees, the State offers a Deferred Compensation Plan for tax deferred savings. 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), Teacher's Retirement System of Louisiana (www.trsl.org), Louisiana School Employees' Retirement System (www.lsers.net), among others. LASERS has provided this video to give you more detailed information about their system. Agency State of Louisiana Address For agency contact information, please refer to the supplemental information above. Louisiana State Civil Service, Louisiana, 70802 Phone (866) 783-5462

  • Industry
    Education
  • Locations
    Los Angeles, CA • Lafayette, LA • Baton Rouge, LA