Medicaid Program Manager 1-A

Posting number: MVA/SP/225078

Department: LDH-Medical Vendor Administration

Job classification: MEDICAID PROGRAM MANAGER 1--A

Posting type: Open & Promotional

Categories: Administration, Health Services, Public Health, Public Relations, Social Services

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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.

• 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.

• Manages the Medicaid Evidence-based Decisions (MED)program in compliance with contract deliverables.
• Assists in the development and management of performance measures as related to Medicaid and the MCOs.
• Provides technical assistance to MCOs in adhering to program policies and contract deliverables that guide program outcomes.
• Serves as a liaison between the Quality team and the Clinical Policy team to utilized at inform programmatic efforts to support evidence-based practice.
• Serves as a liaison for Medicaid Program Manager 2 in collaborating with Healthy Louisiana staff on Clinical Quality Measures (CQM).
• Assists with the administration of the Managed Care Incentive Program(MCIP).
• Implements quality improvement initiatives by analyzing data, conducting literature searches and researching policies, and evidence-based practices to develop manuscripts, fact sheets and policy briefs in direct response to legislative requests.
• Monitors statewide operations to determine efficiency and effectiveness of the delivery of services.
• Assists with the development and review of Managed Care Organization(MCO) contract deliverables

• Position-Specific Details: Location: Medical Vendor Administration / Quality Improvement and Innovations/ East Baton Rouge Parish
• Appointment Type:This position may be filled as aProbationary appointment, Promotional appointment,or Detail to Special Duty
• Cost Center:3052030601
• Position Number(s):50558650
• No Civil Service test score is required in order to be considered for this vacancy.
• 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.

Contact Information:

• Shambrielle Pooler
• LA Department of Health (LDH)
• Division of Human Resources
• PO Box 4818
• Baton Rouge, LA 70821
• 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.

The official job specifications for this role, as defined by the State Civil Service, can be found here.

Make a statewide impact on the quality of healthcare for Louisiana Medicaid members! Join LDH’s Medicaid Quality Improvement team and lead innovative quality improvement initiatives that use data, evidence-based practices, and technology to improve access and outcomes for nearly 1.7 million Medicaid enrollees. As a key program leader, you’ll help shape statewide quality programs, drive meaningful improvements in healthcare delivery, and turn data into action that makes a difference for Louisiana communities.