Medicaid Program Manager 1A (External Audits CMS UPIC Liaison)
Medicaid Program Manager 1A (External Audits CMS UPIC Liaison)Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4628683) ApplyMedicaid Program Manager 1A (External Audits CMS UPIC Liaison)Salary $4,784.00 - $9,381.00 MonthlyLocation Baton Rouge, LAJob TypeClassifiedJob NumberMVA/SP/199036DepartmentLDH-Medical Vendor AdministrationOpening Date08/21/2024Closing Date9/4/2024 11:59 PM Central
Description
Benefits
Supplemental InformationThe 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 / Program Integrity / East Baton Rouge ParishAnnouncement Number: MVA/SP/199036Cost Center: 3052010700Position Number: 50380751This 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 scoreis required in order to be considered for this vacancy.(Include any supplement information from EPAR attachments in this portion)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 willNOTpopulate your information into your application. Work experience left off your electronic application or only included in an attached resume is not eligible to receive creditFor further information about this vacancy contact:Shambrielle PoolerShambrielle.Pooler@la.govLDH/HUMAN RESOURCESBATON ROUGE, LA 70821This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218. Minimum QualificationsMINIMUM QUALIFICATIONS:A baccalaureate degree plus four years of professional experience in administrative services, economics, public health, public relations, statistical analysis, social services, or health services.SUBSTITUTIONS:Six years of full-time work experience in any field may be substituted for the required baccalaureate degree.Candidates without a baccalaureate degree may combine work experience and college credit to substitute for the baccalaureate degree as follows:A maximum of 120 semester hours may be combined with experience to substitute for the baccalaureate degree.30 to 59 semester hours credit will substitute for one year of experience towards the baccalaureate degree.60 to 89 semester hours credit will substitute for two years of experience towards the baccalaureate degree.90 to 119 semester hours credit will substitute for three years of experience towards the baccalaureate degree.120 or more semester hours credit will substitute for four years of experience towards the baccalaureate degree.College credit earned without obtaining a baccalaureate degree may be substituted for a maximum of four years full-time work experience towards the baccalaureate degree. Candidates with 120 or more semester hours of credit, but without a degree, must also have at least two years of full-time work experience tosubstitute for the baccalaureate degree.Graduate training with eighteen semester hours in one or any combination of the following fields will substitute for a maximum of one year of the required experience on the basis of thirty semester hours for one year of experience: public health; public relations; counseling; social work; psychology; rehabilitation services; economics; statistics; experimental/applied statistics; business, public, or health administration.A master's degree in the above fields will substitute for one year of the required experience.A Juris Doctorate will substitute for one year of the required experience.Graduate training with less than a Ph.D. will substitute for a maximum of one year of the required experience.A Ph.D. in the above fields will substitute for two years of the required experience.Advanced degrees will substitute for a maximum of two years of the required experience.NOTE:Any college hours or degree must be from an accredited college or university.Job ConceptsFunction of Work:To administer small and less complex statewide Medicaid program(s).Level of Work:Program Manager.Supervision Received:Broad from a higher-level manager/administrator.Supervision Exercised:May provide functional supervision in accordance with the Civil Service Allocation Criteria Memo.Location of Work:Department of Health and Hospitals.Job Distinctions:Differs from Medicaid Program Monitor by responsibility for administering small and less complex statewide program(s).Differs from Medicaid Program Manager 1-B by the absence of supervisory responsibility.Differs from Medicaid Program Manager 2 by the absence of responsibility for administering medium size and moderately complex statewide program(s).Examples of WorkThe External Audits, CMS UPIC Liaison will be responsible for:
Serving as the Unified Program Integrity Contractor (UPIC) by overseeing all of the daily functions of the UPIC program
Functioning as the subject matter expert (SME) for the CMS (Center for Medicaid Services) contractor
Conducting data reviews for the purpose of identifying potential leads or referrals to CMS contractor
Providing audit referrals based on State interest.
Assessing potential audit targets and approves for investigation.
Approving audit project ideas.
Reviewing and approves audit test plans.
Reviewing contractor's preliminary audit findings and obtains departmental approval.
Assisting CMS contractor with policy or data issues which may arise.
Coordinating with other audit entities to prevent audit duplication.
Working with CMS contractor to identify improper billing.
Processing the recovery of overpayments.
Participating in legal proceedings.
Collaborating on data matching and analysis.
Preserving statistics on open/closed audits and recoveries.
Identifying/planning potential leads for audit.
Clarifying program policy for identification of potential program vulnerabilities.
Providing feedback and updates to partners.
Facilitating monthly conference calls with contractor, CMS, and Program Integrity.
Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity tomake a differencethrough public service. With an array of career opportunities in every major metropolitan center and in many rural areas, state employment provides an outstanding option to begin or continue your career. As a state employee, you will earn competitive pay, choose from a variety of benefits, and have access to a great professional development program:Insurance Coverage More information can be found at https://info.groupbenefits.org/Parental Leave– Up to six weeks paid parental leaveMore information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspxHolidays and Leave – State employees receive the following paid holidays each year:
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.
Additional holidays may be proclaimed by the GovernorState employees earn sick and annual leave which can be accumulated and saved for future use. Your accrual rate increases as your years of service increase.Retirement – State of Louisiana employees are eligible to participate in various retirement systems (based on the type of appointment and agency for which an employee works). These retirement systems provide retirement allowances and other benefits for state officers and employees and their beneficiaries. State retirement systems may include (but are not limited to):
Louisiana State Employees Retirement System (www.lasersonline.org). LASERS has provided this video (https://lasersonline.org/wp-content/uploads/2016/07/YourRetirementSystem.mp4) to give you more detailed information about their system
Teacher's Retirement System of Louisiana (www.trsl.org),
Louisiana School Employees Retirement System (www.lsers.net), among others
AgencyState of LouisianaAddressFor agency contact information, please refer tothe supplemental information above.Louisiana State Civil Service, Louisiana, 70802Phone(866) 783-5462Websitehttp://agency.governmentjobs.com/louisiana/default.cfmApplyPlease verify your email addressVerify Email