Medicaid Program Monitor (Medicaid Fee Schedule and Coding Monitor)

$50,124 - $98,328/Yr

State of Louisiana - Baton Rouge, LA

Full-time - Entry Level

Baton Rouge, LA

Executive, Legislative, and Other General Government Support

About the position

The Medicaid Program Monitor (Medicaid Fee Schedule and Coding Monitor) is responsible for conducting advanced research, analyses, and policy management activities for Medicaid programs within the Louisiana Department of Health. This role involves auditing eligibility enrollment applications, preparing reports, revising rules and regulations, and evaluating the impact of new or revised regulations on the state Medicaid program. The position requires a strong understanding of Medicaid policies and the ability to provide guidance and training to staff.

Responsibilities

• Conduct audits of eligibility enrollment applications and prepare reports on results.
• Prepare, interpret, and clarify eligibility policies and procedures.
• Revise rules, regulations, and procedures to meet changes in law or policy.
• Compile data and propose budgets for subprogram studies and proposed legislation.
• Review current and proposed state and federal regulations for hospitals and home health providers.
• Evaluate new and/or revised regulations to determine their impact on the state Medicaid program.
• Review audits performed by contracted auditors for compliance with policies and regulations.
• Coordinate compliance monitoring of Medicaid Application Centers statewide.
• Approve and schedule requests for Application Center Representative training.
• Advise and assist field staff in performing on-site monitoring reviews.
• Assist in negotiating contractual agreements with Application Centers.
• Provide functional supervision over contract staff and monitor training provided by them.
• Prepare the annual budget request and respond to requests for additional information during the legislative approval process.
• Train staff in fiscal management, budget development, and variance reporting.

Requirements

• A baccalaureate degree plus three years of professional level experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.
• Substitutions available for candidates without a baccalaureate degree, including work experience and college credit combinations.

Nice-to-haves

• Graduate training in relevant fields may substitute for required experience.
• A master's degree in relevant fields may substitute for one year of required experience.

Benefits

• Insurance coverage including health, dental, and vision insurance.
• Paid parental leave of up to six weeks.
• Paid holidays including 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.
• Accrual of sick and annual leave with increasing rates based on years of service.
• Eligibility to participate in various retirement systems.