Job Description

MEDICAL CERTIFICATION SPECIALIST 1 or 2 Print ( Apply ? MEDICAL CERTIFICATION SPECIALIST 1 or 2 Salary $5,119.00 - $9,211.00 Monthly Location Baton Rouge, LA Job Type Classified Job Number 24-082-DD-MCS Department LDH-Capital Area Human Services District Opening Date 10/08/2024 Closing Date 10/18/2024 11:59 PM Central Description Benefits Supplemental Information This position may be filled as: Temporary Job Appointment: This position may be filled by temporary job appointment not to exceed 48 months. Probational Appointment: Current permanent status classified State employees will be required to accept a probational appointment, if selected. About this position: This vacancy is located at Capital Area Human Services District's Developmental Disabilities Division Why work for CAHS? Vision: CAHS excel at making lives better. Mission:To deliver caring and responsive services, leading to a better tomorrow. Philosophy: CAHS commits to the philosophy that all individuals are valuable members of the community. CAHS exist to help each person(s) served live productively in the location and environment of the choosing and abilities. CAHS staff works as a unified team to provide services and supports that helps person(s) served succeed in work, school, life, and other endeavors they purse. As part of a Career Progression Group, vacancies may be filled from this recruitment as a Medical Certification Specialist 1 or 2 depending on the level of education and experience of the selected applicant(s). Medical Certification Specialist 1 (pay grade level MS-518) has a minimum salary of $29.53/hourly; $2,362.40/bi-weekly. Medical Certification Specialist 2 (pay grade level MS-519) has a minimum salary of $31.60/hourly; $2,528.00/bi-weekly. **Note regarding the advertised pay range: The advertised maximum amount listed is the maximum salary a person can make while in this title/level over their career and not the maximum amount we are allowed to pay a new hire. No Civil Service test score is required in order to be considered for this vacancy. REVIEW YOUR APPLICATION TO MAKE SURE IT IS CURRENT. Resumes WILL NOT be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete. 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. There is no guarantee that everyone who applies to this posting will be interviewed. The hiring supervisor/manager has 90 days from the closing date of the announcement to make a hiring decision. Specific information about this job will be provided to you in the interview process, should you be selected. For further information about this vacancy contact: Trina Jenkins Thrinacia.Jenkins2@la.gov Capital Area Human Services District 7389 Florida Blvd, Suite 100 Baton Rouge, LA 70806 Minimum Qualifications MINIMUM 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 Concepts FUNCTION 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 Work EXAMPLES LISTED BELOW ARE BRIEF SAMPLES OF COMMON DUTIES ASSOCIATED WITH THIS JOB TITLE. PLEASE NOTE THAT NOT ALL TASKS ARE INCLUDED. Certify applicants as medically eligible to received Medical Waiver Services. Analyze and review Comprehensive Plans of Care(CPOC) with required documentation to ensure that an individual meets medical eligibility for Waiver Services, initially and annually. 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. Returns incomplete plans to Support Coordination Agency and communicates the need regarding further information and why plan is deemed incomplete. Provides technical assistance to Support Coordination Agencies regarding methods of improving the incomplete plan. Utilizes professional medical knowledge and judgement in evaluation of appropriateness and quality of medical care by assessing individual's overall health, welfare and safety, assuring that provided waiver services meet compliance. Conducts special investigations in response to complaints and prepares report findings. 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. 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. Consult with psychologist, psychiatrist, and/ or physician as needed to reach a final eligibility determination. Utilize professional nursing knowledge and judgment in assessing the delegation of medical tasks, procedures, and treatments to non-licensed staff. 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. Incumbent completes/processes appropriate paperwork for waiver participants transferring into and out of other regions; and paperwork for discharges/closures/inactive status. Act as Liaison to non-waiver participants and other agency/entities. Certifies individuals as medically eligible to receive waiver services. Creates and monitors a continuous quality improvement process. Uses a variety of computer programs and web based systems that are specific to the waiver service delivery system. 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 Parental Leave- Up to six weeks paid parental leave More information can be found at Holidays 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 Governor State 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 ( LASERS has provided this video ( to give you more detailed information about their system Teacher's Retirement System of Louisiana ( Louisiana School Employees Retirement System ( among others Agency State of Louisiana Address For agency contact information, please refer to the supplemental information above. Louisiana State Civil Service, Louisiana, 70802 Phone (866) 783-5462 Website Apply Please verify your email addressVerify Email

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