Medical Certification Specialist (1-2) (Waiver Unit Staff)
State of Louisiana
- Marrero, LA
- $5,119-9,211 per month
- Permanent
- Full-time
For further information about this vacancy contact:
Jill Estes
Jefferson Parish Human Services Authority
3616 S. I-10 Service Road West, Metairie, LA 70001Jefferson Parish Human Services Authority and its programs (JPHSA) participate in E-Verify
Federal law mandates all employers to verify the identity and employment eligibility of all persons hired to work in the United States. All new hires at JPHSA are subject to employment eligibility verification through E-verify.
E-Verify is for Everyone.
For more information on E-Verify, please contact the Department of Homeland Security at 888-897-7781 or visitMinimum QualificationsMINIMUM QUALIFICATIONS:A baccalaureate degree plus two years of professional level experience in hospital or nursing home administration, public health administration, social services, nursing, pharmacy, dietetics/nutrition, physical therapy, occupational therapy, medical technology, or surveying and/or assessing health or social service programs or facilities for compliance with state and federal regulations.SUBSTITUTIONS:A current valid Louisiana license in one of the qualifying fields will substitute for the required baccalaureate degree.A master's degree in hospital administration, nursing home administration, public health administration, social work, nursing, pharmacy, dietetics, nutrition, physical therapy, occupational therapy, or medical technology will substitute for a maximum of one year of the required experience.NOTE:Any college hours or degree must be from an accredited college or university.NOTE:A current valid Louisiana license in an individual field may be required for some positions.Job ConceptsFUNCTION OF WORK:To conduct surveys and/or assessments to verify that the services provided to individuals by providers, facilities, waivers, and/or long term care programs are in compliance with federal certification, state regulations, and established state standards.LEVEL OF WORK:Experienced.SUPERVISION RECEIVED:Broad review from Medical Certification Supervisor or other higher level agency administrator.SUPERVISION EXERCISED:None.LOCATION OF WORK:Department of Health and Hospitals.JOB DISTINCTIONS:Differs from Medical Certification Specialist 2 by the absence of Centers for Medicare and Medicaid Services certification and by the level of independence exercised in carrying out work responsibilities.Examples of WorkEXAMPLES LISTED BELOW ARE BRIEF SAMPLES OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. PLEASE NOTE THAT NOT ALL TASKS ARE INCLUDED.Conducts surveys of health and social services programs, facilities, and providers that are state licensed and/or certified for state and federal programs.Conducts assessments to ensure receipt of quality services by contracted providers.Studies the facility or other Medicaid enrolled provider relative to quality of medical services to determine the extent of compliance with state/federal regulations, state licensing, or established state standards.Obtains information from review of records, staff interviews, resident interviews, personal observations relative to the operation of the medical facility, compliance standards, and quality of medical care provided.Evaluates equipment and environmental factors of the facility for compliance with federal and state regulations.Compiles information derived from surveys or paid Medicaid claims data and reports findings to recommend whether licensure and/or certification should be granted, denied, deferred, continued, or a change in Medicaid reimbursement is warranted.Conducts special investigations in response to complaints and prepares report findings.Certifies individuals as medically eligible to receive waiver services.Creates and monitors a continuous quality improvement process.Approves waiver recipients' comprehensive plan of care and annually evaluates the overall effectiveness of waiver recipients' comprehensive plan of care. Ensures that personal outcomes resulting from the receipt of waiver services are reflective of the person-centered goals identified in their comprehensive plan of care.Conducts quality assurance of case management agencies and service providers relative to organization, policies and procedures, administration, qualifications of staff and quality of services to determine the extent of compliance with Medicaid regulations and waiver recipients comprehensive plan of care.Evaluates the appropriateness and the quality of medical care based on personal observations, interviews, and/or established state performance standards.Receives, reviews, and determines appropriateness of recipient appeals of denied services. Gathers factual information and prepares summary of evidence. Presents testimony before Administrative Law Judge.Louisiana State Government represents a wide variety of career options and offers an outstanding opportunity to make a difference through 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 atParental Leave - Up to six weeks paid parental leave
More information can be found atHolidays 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.