What are the responsibilities and job description for the Medical Certification Manager 1 position at State of Louisiana?
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
This position may be filled in the following parishes: Orleans, Jefferson, St. Bernard, Plaquemine,
The position is domiciled at one of the nine Office of Aging and Adult Services (OAAS) regional Offices and serves as the Regional Manager. The incumbent supervises and monitors the operations of all long term care programs that serve older adults and persons with adult onset disabilities.
Incumbent must possess a thorough knowledge of state and federal Medicaid guidelines and LDH/OAAS rules, policies and procedures in addition to knowledge of the service system for all Medicaid Long Term Care Programs, including Nursing Facilities, Community Choices Waiver (CCW), Adult Day Health Care (ADHC) Waiver, Long-Term-Personal Care Services (LT-PCS), the Program for the All-Inclusive Care for the Elderly (PACE) and community resources.
A bachelor's degree plus five years of experience in hospital or nursing home administration, health services, health regulation, or social services; OR
A master's degree in a health services field, health regulation field, or a social services field plus four years of experience in hospital or nursing home administration, health services, health regulation, or social services.
The official job specifications for this role, as defined by the State Civil Service, can be found here.
Job Duties:
Regional Operation Management
- Administers all regional OAAS programs through direct and indirect supervision of subordinates to ensure programmatic needs are met and assignments are completed timely.
- Plans, organizes and coordinates activities for regional operations. Manages and coordinates the administrative activities of the OAAS regional office.
Support Coordination Monitoring
- Oversees the assignment of monitoring reviews of all support coordination agencies and a representative sample of all participants at least annually utilizing specially developed program monitoring tools. This includes both on-site and in-home reviews, interviews and record reviews as well as ongoing review of performance data.
- Reviews the monitoring results and determined remediation required and its severity for the agency and on behalf of the participant.
Supervision and Staff Management
- Oversees the State Civil Service and contract staff responsible for coordinating the day-to-day duties of the Program Operations Division.
- With the OAAS Leadership Team, establishes and monitors strong recruitment and retention strategies.
- Duties assigned and supervised include, but are not limited to, managing waiver participants' certification, issuing denial/discharge notices with appeal rights as appropriate, completing in field Nursing Facility Level of Care (NFLOC) determinations with individuals and participants, conducting Support Coordination Agency (SCA) monitoring (on-site and data review), providing technical assistance to Direct Service Providers (DSPs) and SCAs, conducting participant home visits and delivering training to SCAs and DSPs statewide.
Program Integrity and Quality Assurance
- Responsible for managing the reporting, review of and response to critical incidents by direct service providers and support coordinators.
- Assures that all participant health and welfare follow-up has been accomplished by providers.
Nursing Facility Outreach, Connection to Services and Level of Care Determinations & Technical Assistance
Position-Specific Details:
Location: Office of Aging and Adult Services / Headquarters - PROGRAM OPERATIONS / Statewide Parish
Appointment Type: This position may be filled as a Probationary appointment
Cost Center: 3201022001
Position Number(s): 190485
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.
For information on how to check your application status and understand status updates, please click HERE.
Contact Information:
Debbie Parris-Thymes
Debbie.Parris-Thymes2@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.
LDH is an equal opportunity employer and seeks to recruit a highly productive and diverse workforce and will provide equal employment opportunities to all employees and prospective employees. Employment decisions shall be based strictly on merit and without regard to religious or political beliefs, sex, race, or any other non-merit factor.
Salary : $6,838 - $12,326