Long Term Care Specialist I

Overview

Make a difference for Vermonters by maintaining an active Medicaid caseload & processing new applications at the Department of Vermont Health Access (DVHA). The Long Term Care (LTC) unit is seeking Long Term Care Specialist I position. Receive in depth training on a broad range of Medicaid programs for: Aged Blind and/or Disabled Long Term Care and Choices for Care. Work in a supportive work environment with a Monday-Friday schedule eleven paid state holidays in addition to a robust benefits package.

The Long Term Care Specialist position has the following responsibilities:
Maintains effective control of an active Medicaid caseload and processes new applications.
60 month Look Back Period to determine if there are applicable penalty periods.
Making complex Medicaid eligibility determinations consistent with rules and policy and within prescribed time frames.
Conduct independent research and analysis prior to meeting with their mentor or supervisor about a case.
Must Take refresher training as appropriate.
Re-determines program eligibility at prescribed time frames or when changes in client circumstances dictate review.
Must complete work in a timely and efficient manner as there are federal timelines standards that the department is held to.

Failure to adhere to those standards may result in financial penalties for the department.
May prepare reports fair hearing requests and fraud referrals.
May testify at Fair Hearings. Performs related duties and other assigned duties as required.
Read and understand detailed instructions in order to accurately perform tasks accordingly.

Work is performed with considerable oversight of LTC Mentors and Supervisors. Workload levels are assigned commensurate with level of experience. The ideal candidate will have strong interpersonal organizational and IT skills.

Mission:
The Department of Vermont Health Access (DVHA)s mission is to improve Vermonters health and well-being by providing access to high-quality cost-effective health care. We have identified three priorities that support our mission: Advancing value-based payments modernizing information technology infrastructure and operational performance improvement. Our department commits to executing our responsibilities and priorities while adhering to three core values: Transparency Integrity and Service.

Diversity Equity and Inclusion:
As part of our values of transparency integrity and service we are committed to supporting diversity equity inclusion and accessibility as part of our person-centered culture. We actively celebrate our colleagues and future colleagues different abilities racial identity sexual orientation ethnicity age and gender. Everyone is welcome and supported here.

Our State:
Vermont is a small but mighty state. We are ranked as one of the top 10 states to raise a family in 2022. We are nationwide leaders for progressive social and educational policies. We are in Northern New England 1.5 hours from Montreal and 3.5 hours from Boston. We have beautiful Lake Champlain the Green Mountains and year-round outdoor activities.

Who May Apply

This position Long Term Care Specialist I (Job Requisition #53788) is open to all State employees and external applicants.
If you would like more information about this position please contact
Resumes will not be accepted via e-mail. You must apply online to be considered.
Please note that multiple positions in the same work location may be filled from this job posting.

AHS BACKGROUND CHECKS: Candidates must pass any level of background investigation applicable to the accordance with AHS Policy 4.02 Hiring Standards Vermont and/or national criminal record checks as well as DMV and adult and child abuse registry checks as appropriate to the position under recruitment will be conducted on candidates with the exception of those who are current classified state employees seeking transfer promotion or demotion into an AHS classified position or are persons exercising re-employment (RIF) rights.

Environmental Factors

Duties are performed largely in an office setting. Workload usually heavy with constant need for prompt and accurate decisions. May experience frequent interruptions and shifting of priorities. Incumbents must be able to function independently. Private means of transportation should be available for necessary travel to training mentoring and/or meetings. Applicants may provide a variety of challenges including but not limited to highly emotional conditions: belligerency inability to communicate attempts at falsification and total discouragement. May communicate with private attorneys engaged by applicants to help client with Long Term Care application and eligibility process. May consult with DVHA and/or AAG attorneys regarding fair hearings extraordinary eligibility issues rules interpretation or to gain assistance in responding to questions from clients assistors or outside attorneys.

Minimum Qualifications

Bachelors Degree

OR

Associates degree AND two (2) years or more of experience in a field related to health care administration insurance banking accounting para-legal services auditing or federal grants management. Other related work environments may be considered if they require: reading comprehension and application of complex rules regulations policies and procedures to perform the work.

OR

High School diploma or equivalent AND three (3) years or more of experience in a field related to health care administration insurance banking accounting para-legal services auditing or federal grants management. Other related work environments may be considered if they require: reading comprehension and application of complex rules regulations policies and procedures to perform the work.

Total Compensation

As a State employee you are offered a great career opportunity but its more than a paycheck. The States total compensation package features an outstanding set of employee benefits that are worth about 30% of your total compensation including:

• 80% State paid medical premium and a dental plan at no cost for employees and their families
• Work/Life balance: 11 paid holidays each year and a generous leave plan
• State Paid Family and Medical Leave Insurance (FMLI)
• Two ways to save for your retirement: A State defined benefit pension plan and a deferred compensation 457(b) plan
• Tuition Reimbursement
• Flexible spending healthcare and childcare reimbursement accounts
• Low cost group life insurance
• Incentive-based Wellness Program
• Qualified Employer for Public Service Student Loan Forgiveness Program

Want the specifics Explore the Benefits of State Employment on our website.

Equal Opportunity Employer