Job Information
Louisiana Department of State Civil Service Medical Certification Specialist 1-2 in Statewide, Louisiana
Medical Certification Specialist 1-2
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Medical Certification Specialist 1-2
Salary
$5,119.00 - $9,211.00 Monthly
Location
Statewide, LA
Job Type
Classified
Job Number
OS/DRT/196406
Department
LDH-Office of Secretary
Opening Date
06/20/2024
Closing Date
6/27/2024 11:59 PM Central
Description
Benefits
Supplemental Information
The 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 / Office of the Secretary / Health Standards / Statewide - Region 6
Announcement Number: OS/DRT/196406
Cost Center: 3071040216
Position Number(s): 159854 and 160517
This vacancy is being announced as a Classified position and will be filled as a Probationary appointment.
Preference given to applicants with a LA Registered Nurse Licensure.
No Civil Service test scoreis required in order to be considered for this vacancy.
Position may be filled in either Allen, Avoyelles, Beauregard, Catahoula, Concordia, Evangeline, Grant, LaSalle, Natchitoches, Rapides, Sabine, Vernon, or Winn parish.
LDH/OS/Health Standards Section has a Special Entrance Rate (SER) for employees that are in possession of a valid Louisiana registered nurse license to practice professional nursing, a multi-state license issued by a Nursing Licensure Compact (NLC/eNLC) state, or a licensed physician (Doctor of Medicine).
Medical Certification Specialist 1 - $2,924.80 bi-weekly
Medical Certification Specialist 2 - $3,129.60 bi-weekly
Job Duties
Incumbent is located in the LDH/OS/Health Standards Section. This section is responsible for the licensing and certification of all healthcare programs located in the state. HSS currently licenses/certifies over 35 different healthcare provider types including over 8500 entities. These investigators require intense training and specialized certifications to achieve and maintain proficiency in determining compliance with the thousands of regulations that are inclusive of these programs. This compliance is required to ensure the health, safety and welfare of all citizens of this State who receive services in these licensed/certified healthcare facilities. The incumbent must have the knowledge, skills, abilities and training in the appropriate healthcare areas to ensure applicable standards of appropriate care are being followed. This requires a high level of critical thinking skills, autonomy and decision making skills in addition to intense investigation skills to determine regulatory compliance. The ever changing world of regulatory compliance requires that this incumbent be extremely dynamic with changing processes and a quick study to learn and apply these changing processes and interpretations. Failure to perform the duties in this position could adversely affect health related service delivery in the State and could result in millions of dollars in federal disallowance to the state and the interruption of health delivery to hundreds of thousands of consumers.
60% Conducts surveys with certified surveyor/surveyors on approximately 35 different health care providers/suppliers that operate in the State, This is done to determine conformity with state and federal regulations relative to licensure and certification which requires a broad knowledge of all state and federal program requirements. Conducts a facility review relative to organization, policies, and procedures, administration and quality of services to determine the extent of compliance with the state licensure standards and Medicare and Medicaid regulations, Obtains information from review of records, personnel interviews, resident interviews, and personal observations relative to the delivery of healthcare services and relative to the aspects of the operation of the facility and compliance standards. Compiles information derived from surveys, prepares reports on results of the surveys; describes findings as related to established program procedures and processes; determines conclusions based upon facts obtained, and formulates reports of these findings to enable the program desks to determine whether licensure or certification should be granted, denied, or altered depending upon established laws and regulations. When necessary, testifies in legal hearings relative to survey findings. Performs all surveys in a professional manner at all times, adheres to all assigned mandates, follows directions as given by supervisor, and assures accurate completion of duties in accordance with established state and federal guidelines and timelines, Participates in an ongoing quality assurance program to ensure program integrity.
40% Conducts special investigations with certified surveyor/surveyors in response to complaints and prepares reports of findings. Interprets state and federal regulations to providers/suppliers as needed. Cooperates with administrators of facilities and professional groups in the preparation and presentation of education programs for healthcare providers and staff Participates in an ongoing quality assurance program to ensure program integrity.
As part of a Career Progression Group, vacancies may be filled from this recruitment as a Medical CertificationSpecialist1 or 2depending on the level of experience of the selected applicant(s). The maximum salary for the Medical Certification Specialist 2 is $118,269. Please refer to the 'Job Specifications' tab located at the top of the LA Careers 'Current Job Opportunities' page of the Civil Service website for specific information on salary ranges, minimum qualifications and job concepts for each level.
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 credit
For further information about this vacancy contact:
Deanda Thymes
Deanda.Thymes@la.gov
LDH/HUMAN RESOURCES
BATON ROUGE, LA 70821
225 342-6477
This organization participates in E-verify, and for more information on E-verify, please contact DHS at 1-888-464-4218.
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.
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 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 leave
More information can be found athttps://www.civilservice.louisiana.gov/Parental-Leave/Default.aspx
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 (www.lasersonline.org). LASERS has provided this video (https://lasersonline.org/wp-content/uploads/2016/07/Your_Retirement_System.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
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
http://agency.governmentjobs.com/louisiana/default.cfm
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