Medical Certication Specialist 1 Or 2 Waivers
Medical Certication Specialist 1 Or 2 Waivers
Posted on :
23-09-2025
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1 Vacancy
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Job Description
About this Job
Why work for CLHSD
- Vision:CLHSD excels at making lives better.
- Mission: to increase public awareness of and to provide access for individuals with behavioral health and developmental disabilities.
- Philosophy: to integrate community-based services while promoting wellness recovery and independence through education and choice of a broad range of programmatic and community resources.
Were looking for a Medical Certification Specialist 1 or 2 to use highly developed professional skills to provide technical assistance consultative services programmatic oversight and direction to support coordination agencies as well as service agencies and Support & Service Centers regarding quality of services compliance with Medicaid guidelines for waiver certification assuring health and safety of HCBWS consumers and service delivery. Employee must be knowledgeable of and familiar with the region-wide resources in order to recommend/refer individuals and/or service agencies to such for assistance.
AN IDEAL CANDIDATE SHOULD POSSESS THE FOLLOWING COMPETENCIES:
Selected Preferred Competencies:
- Accepting Direction: The ability to accept and follow directions from those higher in the chain of command.
- Acting Decisively: The ability to make decisions quickly and effectively.
- Communicating Effectively: The ability to relay information correctly and appropriately to connect people and ideas.
- Driving Results: The ability to identify important goals and work to achieve them.
- Focusing on Customers: The ability to serve the needs of those who support and/or rely on the services provided.
- Following Policies and Procedures: The ability to comply with policies and procedures of the organization as well as State Civil Service rules and all applicable federal and state laws.
- Making Accurate Judgments: The ability to form an opinion objectively and decisively based on relevant information and in accordance with established standards.
- Working Safely: The ability to maintain safety by following rules and procedures.
Minimum Qualifications
- A current Louisiana license in a health services field health regulation field or social services field plus two years of experience in hospital or nursing home administration health services health regulation or social services; OR
A bachelors degree plus two years of experience in hospital or nursing home administration health services health regulation or social services; OR
A masters degree in a health services field health regulation field or a social services field plus one year of experience in hospital or nursing home administration health services health regulation or social services. Job Specification
- The official job specifications for this role as defined by the State Civil Service can be found here.
Job Duties and Other Information
- Job Duties:
- Receives and reviews in detail all components of an individuals initial comprehensive plan of care package for approval of home and community-based services making a determination decision within 10 business days of receipt as identified in federal and state Medicaid guidelines.
- Upon receipt of all initial comprehensive plans of care for a new applicant incumbent must visit the individuals home to discuss service requested ensure freedom of choice was offered assess the effectiveness and quality of planning process ensure personal goals and outcomes are identified and are addressed in the comprehensive plan of care and assess health and safety components for community living. Incumbent provides recommendations to the Support Coordination Agency and/or Service Provider Agency based on information gathered at the initial home visit.
- Annually and as needed the incumbent will review and evaluate overall effectiveness of individuals comprehensive plans of care ensuring personal outcomes and person-centered goals are identified appropriately within each plan of care as well as evaluate how support identified will ensure the individuals health and safety in the community setting.
- All returns or denials of incomplete plans to Support Coordination Agencies are provided with the incumbent providing communication via written communication through Louisiana Statistical Resources System (LaSRS) to Support Coordination Agencies regarding methods of improving or clarifying requested service support.
- Incumbent identifies coordinates and communicates with supervisor regarding recurring issues/problems with Support Coordination Agencies regarding methods of improving comprehensive plans of care submitted to Waiver Supports and Services Unit.
- Incumbent receives emergency and non-emergency service plan revisions to review for the appropriateness of changes in services that are requested and necessary for the care of the individual.
- For all denials of home and community-based waiver services requested incumbent prepares a notification letter to the individual or family detailing the reason for denial based on policy and procedure.
- As assigned by administrative staff incumbent follows all assigned critical incident reports submitted electronically into the SIMS (Statewide Incident Management System) by the Support Coordination and Provider Agencies.
- High Risk situations require more in-depth involvement by incumbent in planning and may require active participation in the assessment and planning process; including on-going interaction with Interdisciplinary Team Members (IDT) and/or possible on-site home visit with the participant to ensure the health and safety of the participant.
- Completes Level of Care (LOC) assessments and approval/denial of ACT 421 Childrens Medication Option applicants to include reviewing each case annually thereafter for continued eligibility. Associated tasks also include monitoring and managing the ACT 421 email to include correspondence with Central Office and Medicaid as needed and maintaining updated forms/policies maintaining the information in the share drive completing quarterly updates to Central office maintaining billing invoices and maintaining information in the Participant Database.
- Incumbent has routine interaction with Statistical Resource Institute (state data contract agency) to review and respond to any area of concerns regarding billing/documentation for home and community-based waiver services and/or registry date information discrepancy for services requested.
- Conduct annual monitoring reviews at contracted Support Coordination Agencies to ensure the agency meets guideline standards set in the Medicaid Case Management Provider manual and to ensure services are provided and documented appropriately. Involves review of recipient records on-site visits at recipients home assessment of provider compliance with standards and quality of service delivery.
- Assist BHSF Waiver Monitoring Unit by providing any and all documentation for survey materials as requested.
- Incumbent will provide information training and technical assistance to Support Coordinators Service Provider Agencies and individuals/families in regard to home and community-based waiver supports and services when requested.
- Incumbent completes quarterly Level of Care/Plan of Care (LOC/POC) monitoring by completing record reviews of waiver recipients to ensure staff accountability proper implementation of waiver policies and procedures and determine compliance with guidelines outlined is state and federal Medicaid policy and procedures.
- Incumbents participate in emergency preparedness training shelter duties and activities as assigned by supervisor.
- Incumbent performs additional duties as assigned by supervisor.
Position-Specific Details:
Appointment Type:This position may be filled by a probational appointment.
Location: This vacancy is located at the Central Louisiana Human Services District. This announcement serves to fill vacancies in our Waivers Department in Alexandria.
Compensation: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.
Louisiana is a State As a Model Employer (SAME) that supports the recruitment hiring and retention of individuals with disabilities.
How To Apply:No Civil Service test scoreis 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.
Information to support your eligibility for this job title must be included in the application (i.e. relevant detailed experience/education). Resumeswill not be accepted in lieu of completed education and experience sections on your application. Applications may be rejected if incomplete.
Contact Information:
For further information about this vacancy contact:
Central Louisiana Human Services District
5411 Coliseum Blvd.
Alexandria La 71303
Required Experience:
Unclear Seniority
Employment Type
Unclear
Key Skills
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