Medicaid Program Manager 2

The Louisiana Department of Health is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.

LDH serves as a model employer for individuals with disabilities.

This position is located within the Louisiana Department of Health / Medical Vendor Administration / Business Analytics / East Baton Rouge Parish
 
Announcement Number: MVA/SP/206082

Cost Center: 3052010301

Position Number: 50561088

This vacancy is being announced as a Classified position and may be filled as a Job appointment, Probationary appointment, Promotional appointment or Detail to Special Duty.

(Job appointments are temporary appointments that may last up to 48 months)

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.

*Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.*

A resume upload will NOT populate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive credit

For further information about this vacancy contact:

Shambrielle Pooler

Shambrielle.Pooler@la.gov

LDH/HUMAN RESOURCES

BATON ROUGE, LA 70821

This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.    

MINIMUM QUALIFICATIONS:
Seven years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

Six years of full-time work experience in any field plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

A bachelor’s degree plus four years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services; OR

An advanced degree or a Juris Doctorate plus three years of experience in developing, managing, or evaluating health or social service programs; or in public health, public relations, social services, health services, health regulation, or administrative services.

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.Function of Work:
To administer medium size and moderately complex statewide Medicaid program(s).

Level of Work:
Manager.

Supervision Received:
Broad from a higher-level administrator/executive.

Supervision Exercised:
Supervision over lower level positions in accordance with the Civil Service Allocation Criteria Memo.

Location of Work:
Department of Health and Hospitals.

Job Distinctions:
Differs from Medicaid Program Manager 1-A and Program Manager 1-B by administering medium size or moderately complex statewide program(s) and supervision exercised.

Differs from Medicaid Program Manager 3 by absence of responsibility for administering large and/or very complex Medicaid program(s) and supervision exercised.

The mission of the Louisiana Department of Health (LDH)is to protect and promote health and to ensure access to medical, preventive and rehabilitative services for all citizens of the State of Louisiana. LDH is dedicated to fulfilling its mission through direct provision of quality services, the development and stimulation of services of others, and the utilization of available resources in the most effective manner.

This unique, highly complex, responsible and experienced position is in the Business Analytics section within the Bureau of Health Services Financing(BHSF},Louisiana’s single state Medicaid agency within the Louisiana Department of Health(LDH}.The Louisiana Medicaid Program, which provides healthcare services to low-income individuals, has an annual budget of approximately $12.9billion dollars, a staffing complement of almost 900 authorized employees and almost 500 contracted direct-support staff, and provides services to approximately 1.7 million enrollees annually. The program is a state of federal partnership financed with a combination of state and federal funds and governed by a complex body of state and federal laws,policies,regulations,and, and guidelines.

The incumbent will serve as the Unit Manager over the new centralized unit for Medicaid Reporting. The position will be directly responsible for ensuring accuracy and reliability of data collected and reported across all areas of Medicaid statewide, including but not limited to the compilation of data for LDH Medicaid reports. Due to the vast scope and complexity of the statewide reporting, it is crucial that the department create a centralized reporting unit. This unit is essential to review and analyze the large amounts of complex, multi-source data as well as system reports to ensure compliance with state and federal requirements.

The position reports directly to the Medicaid Program Manager 4(Section Chief} and is a part of a team providing support to the Louisiana Medicaid Director and Medicaid Deputy Director of Finance. The Medicaid Reporting Unit will manage two reporting programs: Quality Assurance Program and Transparency Program. Due to the complexity of the position, it requires the incumbent maintain a high-level knowledge of all programs within Medicaid. The incumbent must be attentive to detail, able to focus on different projects at one time, manage time wisely, work independently, apply Medicaid rules and policies, and be proactive in seeking input from other staff within LDH. The incumbent would preferably have the following skills: Excellent written and verbal communication; strong organizational skills; demonstrated team leadership; and experience in project management, healthcare administration, health plan operations and healthcare policy research and analysis.

The incumbents' responsibilities include but are not limited to the following duties:

50%    Administers the day-to-day operational functions, reviews and analyzes large amounts of complex, multi-source data as well as system reports to ensure compliance with program regulations. Manages and directs overall goals and objectives of the programs, sets strategic direction and informs staff of the Louisiana Medicaid program statewide regarding data analysis. Reviews reports generated by the Business Analytics team to ensure data accuracy and reasonableness. Assures proper application of program policies and procedures. Also, analyzes the impact of federal and state laws and regulations relevant  to the Business Analytics section and advises executive management as needed regarding issues. Researches policies and directs research for the operation of the same within Louisiana Medicaid. Provides technical assistance to subordinate staff, other departmental staff, health plans, providers and the public as necessary.

Leads multi-disciplinary teams by planning and coordinating to ensure completion of accurate and timely reports in accordance with state and federal requirements. Serves as the reporting team leader by planning, developing and monitoring the program policies including the reports and data analysis for the Business Analytics section. Supervises the coordination of external Medicaid reporting requirements as well as internal reporting on programs and activities across the department related to program quality, program compliance, member services, program utilization and program expenditures. Analyzes multi-billion-dollar Medicaid claim data and directs preparation of reports/analyses for Medicaid Deputy Director, Medicaid Director, Undersecretary or Secretary.

20% Serves as liaison between all business users and technical staff (analytics, IT, statistics, and economists}. Analyzes requestor's data needs and end products.

Assists in designing internal reports, interpreting data and formulating appropriate conclusions supported by the data. Identifies and documents any data limitations and biases that might affect the results. Collaborates with executive management and program staff to respond to information requests. Ensures the appropriate translation of information requests to technical data staff. Reviews and analyzes resulting data to identify any anomalies or outliers. Set directions for utilization analyses for selected programs.

Collaborates with Business Analytics staff and other LDH staff to ensure complete and successful operationalization of Medicaid Reporting. 

Directs the creation of dashboards to comprehensively report on departmental initiatives. Leads data compilation for annual managed care transparency reports, Medicaid annual report, while ensuring quality inputs and meaningful outcomes. Responsible for ensuring accuracy and reliability of data collected and reported across all areas of Medicaid statewide

15% Provides direct supervision of two (2) employees. Establishes performance goals and objectives, and determines evaluation criteria for employee performance. Schedules and participates in performance planning and reviews conferences and completes formal performances appraisals. Assures that personnel actions of subordinates comply with Civil Service and LDH policies, Medical Vendor Administration policy and Equal Employment Opportunity Act personnel regulations. Interviews and hires for management positions with the Section. Makes recommendations concerning staffing needs to the Medicaid Director and Deputy Director, and submits recommendations regarding appointments, promotions, and discipline or dismissal of staff,in accordance with Civil Service and LDH rules.

Identifies staff development needs in the unit under his/her scope of supervision and ensures that appropriate training is obtained. Conducts staff meetings within the unit to disseminate information and provide expertise and guidance on work assignments, policy, special projects and technical problems.

10%The incumbent conducts and directs research and special projects pertaining to the Business Analytics section as assigned by the Medicaid ProgramManager4(Section Chief), the Deputy Director or the Director of Medicaid. The incumbent performs functions that are necessary for optimum service delivery which promote collaboration, and assists with and attends seminars, workshops, In-service trainings and other capacity building initiatives as required.

5%    Conducts and directs studies and/or special projects pertaining to programs as assigned. Performs other duties and functions as assigned including but not limited to assisting other Business Analytics Program Managers not listed here in in order to meet the needs and functions of the Business Analytics and the Department.

Salary : $5,477 - $10,740