Thank you for your interest in The University of New Orleans.

Once you start the application process, you will not be able to save your work, so you should collect all required information before you begin. The required information is listed below in the job posting.

You must complete all required portions of the application and attached the required documents in order to be considered for employment.

Department

Quality Control

Job Summary

Job Description

* Review 20 to 40 assigned eligibility cases monthly for compliance with policy and procedure, using documentation found within various Medicaid systems and data sources. Further investigation using external information may sometimes be required.

* Interpret and apply Medicaid and CHIP eligibility policies, procedures, rules and regulations.

* Make determination of the correctness of the agency's eligibility decision to approve or deny the specific category of Medicaid or CHIP coverage. Identify deficiencies in systems documentation relative to review elements such as income, household, resources, citizenship, etc.

* Maintain high degree of knowledge relative to changes to Medicaid policy and procedures.

* Maintain high degree of proficiency navigating Louisiana's Medicaid eligibility determination system.

* Generate and maintain detailed and organized audit documentation and exhibits, such as screenshots, third party data, copies of policies, etc.

* Complete special projects as assigned by LDH.

* Monitor eligibility cases for corrective actions made by the Eligibility Program.

* Attend meetings with Medicaid staff.

* Assist with the development of systems and applications utilized by LDH to capture case review information electronically for reporting and statistical computations.

* Other tasks as directed.

Required Qualifications:

* Bachelor's degree or 6 years of professional work experience in lieu of degree.

* Minimum one year of professional experience working with Medicaid/CHIP programs.

* Knowledge of eligibility requirements and/or procedures relative to state medical coverage programs.

* Excellent analytical skills, effective organizational and time management skills.

* Great attention to detail and follow up, and verbal/written communications skills.

Desired Qualifications:

* Advanced degree.

* Minimum two years of professional experience working with Medicaid/CHIP programs.

* Minimum one year of professional experience working Medicaid/CHIP eligibility cases.

* Minimum one year of professional experience with auditing.

* Relevant industry certifications.

Required Attachments

Please upload the following documents in the Resume/Cover Letter section.

* Detailed resume listing relevant qualifications and experience;

* Cover Letter indicating why you are a good fit for the position and University of Louisiana Systems;

* Names and contact information of three references;

* Diversity Statement (required for all Faculty positions and any Staff position of Assistant Manager and higher).

See Diversity Statement instructions by clicking this link: https://www.uno.edu/careers/diversity-instructions

Applications that do not include the required uploaded documents may not be considered.

Posting Close Date

This position will remain open until filled.

Note to Applicant:

Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.

References will be contacted at the appropriate phase of the recruitment process.

This position may require a criminal background check to be conducted on the candidate(s) selected for hire.

As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.

The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.